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Intracytoplasmic Sperm Injection (ICSI) is a form of micromanipulation that involves injecting a single sperm into the cytoplasm of the egg by using a microneedle. Certain groups of patients with a lesser chance of becoming pregnant with routine IVF may require this technologically advanced procedure. When the husband's sperm are considered to be suboptimal, ICSI is performed. ICSI is also performed in situations where characteristics of the egg may impair conventional in vitro fertilization, such as patients with endometriosis or unexplained infertility. Pregnancy rates depend on the number and quality of embryos transferred.

There can be no guarantee, however, that all eggs fertilized will produce an embryo, with or without the use of micromanipulation. IVF technology is not yet capable of determining which eggs will fertilize, or which ones will produce the most viable embryos.

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