[Intracytoplasmic sperm injection--importance and challenge]

The male factor is going to be one of the major problems in the treatment of infertility. In addition to the standard methods of assisted reproduction new microtechniques of assisted fertilization have been developed to increase success rate in cases of male factor infertility. Of these methods especially intracytoplasmatic sperm injection (ICSI) has been described as beneficial in which one spermatozoa is injected directly into oolemma of an oocyte. ICSI can be carried out with ejaculated spermatozoa, with epididymal spermatozoa and with spermatozoa isolated from a testicular biopsy. In all cases high fertilization and pregnancy rates comparing with standard in-vitro fertilization were achieved. It may be recommended that the couples undergo prenatal diagnosis and participate in a prospective follow-up study of children born after ICSI. In management of ICSI all specialists in gynecology, embryology, andrology, medical genetics and urology should go together.