Male infertility and intracytoplasmic sperm injection (ICSI).

Micro-assisted fertilization in the form of intracytoplasmic sperm injection (ICSI) has truly revolutionised the treatment options for couples with impaired semen quality, and those with both obstructive and non-obstructive azoospermia. In general, the major issues which relate to the success of ICSI are those related to the success of conventional IVF, and the high multiple pregnancy rate remains a major cause for concern. There is growing evidence that the short-term health of ICSI offspring is relatively unremarkable, but our growing understanding of the genetic basis of much of male subfertility and of the impaired genomic integrity which characterises the oligozoospermic phenotype indicate a cautious approach to the longer term health of ICSI offspring.