ABSTRACT
Intracytoplasmic sperm injection (ICSI) was initially introduced in the early 1990s as a treatment for male factor infertility. Nowadays, ICSI is considered one of the gold standards for fertility treatment and is offered to a significant portion of couples in need of assisted reproduction. One of the advantages of ICSI is that only a single spermatozoon is required to fertilize each retrieved oocyte. This, however, presents a unique challenge since the single spermatozoosn used during ICSI does not always reflect the overall quality seen in the whole ejaculate. Therefore, traditional methods for assessment of male fertility would be of lesser value in determining ICSI outcomes. In support, the routine semen analysis, which is the main pillar for male fertility workup, has been labeled as a test that possesses limited predictive ability, even when conducted under appropriate controls (1).
