Concierge fertility · London
ICSI in London, done in an HFEA-licensed lab.
Intracytoplasmic Sperm Injection — the IVF add-on that solves severe male-factor infertility, previous fertilisation failure and surgical sperm cases. Done by a senior embryologist, in an HFEA-licensed London centre we have vetted.
Why patients choose us
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A consultant embryologist, not a technician
ICSI is a micromanipulation skill. The injection is done by a senior HFEA-registered embryologist, not a trainee — that is who the outcome depends on.
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We say when ICSI is not needed
If your semen analysis is normal and there is no history of fertilisation failure, conventional IVF is usually enough. We tell you that before you pay for ICSI.
- 03
Independent, and free
We are paid by no clinic, so the recommendation — ICSI, IVF, IUI or donor sperm — is impartial and costs you nothing.
Indicative pricing
What private ICSI costs in London.
Indicative ranges across our HFEA-licensed partner centres. Send us your semen analysis and cycle history and we will quote firm figures across two or three options.
In short
A full IVF cycle with ICSI in our network: £5,000–£8,500, drugs and monitoring included.
| Procedure | Indicative range | Typical duration | Result timing |
|---|---|---|---|
| ICSI add-on to an IVF cycle | £1,000–£1,500 | Same cycle | Fertilisation check next day |
| Full IVF cycle including ICSI | £5,000–£8,500 | 4–6 weeks | Test 2 weeks after transfer |
| IMSI (high-magnification sperm selection) | £400–£900 | Same cycle | Same day |
| PESA / TESA (sperm retrieval, LA) | £2,000–£3,000 | Day-case | Same visit |
| TESE / MicroTESE (surgical retrieval) | £3,000–£4,500 | Day-case GA | Fresh to lab same day |
| Fertility consultation only | £250–£450 | 45 min | Same visit |
Prices vary by clinic, by drug protocol, and by whether surgical sperm retrieval or high-magnification selection is added. NHS-funded ICSI is available via NICE CG156 where you meet local ICB eligibility. We come back with a firm quote within one working day.
The problem
The right IVF add-on, for the right couple — not routinely.
ICSI is a brilliant technology for severe male-factor infertility. It is also the most over-sold add-on in fertility medicine. We help you tell the two apart before you spend.
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Do you actually need ICSI?
If the semen analysis is normal and fertilisation has never failed before, conventional IVF is usually enough. We say so.
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No sperm in the ejaculate?
Surgical retrieval — PESA, TESA, TESE or MicroTESE — coordinated with a fresh embryology slot on the same day.
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Want an HFEA-licensed team?
A senior HFEA-registered embryologist, an operating microscope for MicroTESE, and full genetic counselling where indicated.
The journey
From enquiry to pregnancy test — what happens, in order.
One clinical lead from first message to embryo transfer — including the fertilisation check and the two-week wait.
Phase 1 · Before the cycle
Concierge, off-stage for you
Phase 2 · On the day
Egg collection and ICSI
Phase 3 · After
Culture, transfer, review
- 01
Before
You tell us what is going on
A short, confidential form. Semen analysis results, any previous IVF cycles, whether surgical sperm retrieval has been discussed.
- 02
Before
We come back with a recommendation
Within one working day: whether ICSI is genuinely indicated, whether IVF alone would do, and which HFEA-licensed centre fits your case.
- 03
Before
We arrange the consultation
Usually within one to two weeks. Genetic counselling is arranged first if there is severe male-factor or a known chromosomal cause.
- 04
On the day
Oocyte collection and sperm prep
Egg collection under sedation, sperm produced or thawed the same morning, and prepared under the microscope in the embryology lab.
- 05
On the day
The ICSI procedure itself
A single motile sperm is immobilised and injected directly into each mature oocyte using a micropipette. Done in the lab, not the theatre.
- 06
On the day
Fertilisation check
16–18 hours later, the embryologist checks each oocyte for two pronuclei — the sign that normal fertilisation has occurred.
- 07
After
Embryo culture, transfer and review
Embryos are cultured to day 3 or day 5, one is transferred, any remaining are frozen. A pregnancy test follows two weeks later.
Typical end-to-end: 4–6 weeks for a full stimulated cycle. Fertilisation check: 16–18 hours after ICSI.
When it helps
When ICSI is genuinely the right step.
The clinical situations where ICSI meaningfully changes the answer — and the one situation where the evidence says not to bother.
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Severe male-factor infertility
Oligozoospermia under 5 million/ml, poor motility, or Kruger strict morphology under 4% normal forms.
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Azoospermia + surgical sperm retrieval
No sperm in the ejaculate — sperm harvested by PESA, TESA, TESE or MicroTESE and used fresh or frozen for ICSI.
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Previous IVF fertilisation failure
A complete or near-complete failure of fertilisation in a previous conventional IVF cycle — ICSI usually solves this.
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Severe anti-sperm antibodies
Antibodies that prevent sperm binding the egg — ICSI bypasses the block by injecting directly.
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Retrograde ejaculation
Sperm recovered from post-ejaculation urine — usually low numbers, so ICSI gives the best chance per sperm.
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Frozen or limited-quantity sperm
Cryopreserved samples with limited volume — for example post-chemotherapy storage or donor straws — ICSI uses each sperm efficiently.
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Serodiscordant couples (HIV+ male)
Sperm washing followed by ICSI, in an HFEA-licensed centre with the appropriate infectious-disease protocols.
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Not usually indicated
Unexplained infertility with a normal semen analysis — meta-analyses show no benefit of ICSI over conventional IVF. We say so.
Procedure options
ICSI variants, and how sperm is retrieved.
The technique itself, the surgical routes to retrieve sperm when there is none in the ejaculate, and where donor sperm sits in the picture.
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Standard ICSI
A single motile sperm injected into each mature oocyte — the technique that made severe male-factor infertility treatable.
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IMSI (high-magnification selection)
Intracytoplasmic Morphologically-selected Sperm Injection at over 6000× magnification. Evidence is mixed — we say when it is worth paying for.
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PESA — percutaneous epididymal aspiration
A day-case procedure under local anaesthetic for obstructive azoospermia — post-vasectomy, CBAVD, epididymal obstruction.
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MESA — microsurgical epididymal aspiration
A microsurgical version of PESA giving higher yield — used when a larger sperm reserve is wanted for freezing.
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TESA — testicular sperm aspiration
Needle aspiration from the testis under local anaesthetic — used for non-obstructive azoospermia as a first-line retrieval.
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TESE — open testicular biopsy
An open surgical biopsy under GA giving a higher yield than TESA — preferred when TESA has failed or reserves are known to be low.
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MicroTESE — microsurgical dissection
The highest-yield technique for severe non-obstructive azoospermia — done under the operating microscope, coordinated with a fresh embryology slot.
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Donor sperm + ICSI
If your own sperm cannot be used, HFEA-regulated donor sperm can be combined with ICSI — with the identity-release rules explained beforehand.
Our vetted London network
HFEA-licensed centres only — we picked them.
HFEA-licensed fertility centres across central, north, west and south London, each with an embryology team we know and a urology partner for surgical sperm retrieval.
Selection criteria
How we choose every fertility centre in our network.
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HFEA-licensed fertility centres only — no exceptions
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Senior HFEA-registered embryologists perform the ICSI, not trainees
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Urology partner for surgical sperm retrieval (PESA, TESA, TESE, MicroTESE)
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Genetic counselling arranged before ICSI where male-factor cause is inherited
Safety and outcomes
What to expect — honestly.
The success rates, the fertilisation rate, the small increases in risk that have been reported, and the long-term picture for children conceived by ICSI.
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ICSI does not fix every fertility problem
ICSI solves the sperm-meeting-egg step. It does not overcome poor egg quality, uterine problems or embryo genetic issues. We are honest about what it can and cannot do.
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Success is similar to IVF for the right patient
For male-factor indications, per-transfer live-birth rates are broadly comparable to IVF. For non-male-factor couples, ICSI does not improve outcomes.
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Fertilisation is not guaranteed
Around 70–80% of mature oocytes fertilise normally after ICSI. Some fail to fertilise even with a sperm placed inside — the egg has the final say.
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Small increase in congenital anomaly risk
Adjusted odds ratio around 1.2–1.3 versus natural conception, mostly linked to the underlying subfertility rather than to ICSI itself.
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Inherited male infertility can be passed on
Y-chromosome microdeletions and CFTR (CBAVD) mutations can be transmitted to sons. Genetic screening and counselling are offered before treatment.
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Imprinting disorders are rare but real
A small increased risk of Beckwith–Wiedemann and Angelman syndromes has been reported — absolute risk remains very low.
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Long-term child outcomes are reassuring
Cognitive, physical and behavioural outcomes in ICSI-conceived children are broadly similar to naturally-conceived children in long follow-up studies.
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HFEA consent and storage rules apply
You will sign HFEA consent for use, storage and disposition of gametes and embryos. Donor-conceived children born after April 2005 can access identity information at 18.
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Red flags
Heavy pelvic pain, breathlessness or severe bloating after egg collection can signal OHSS — call the clinic the same day, and A&E if severe.
Reading your cycle report
Your cycle report in four parts. Read the last one first.
Whichever centre you use, the embryology report from an ICSI cycle keeps to the same shape.
A quiet reminder
Embryology language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the report before your review appointment, just ask.
- 01 Header
Indication and cycle plan
Why ICSI was chosen — male-factor, previous fertilisation failure, surgical sperm — and how the cycle was stimulated and timed.
- 02 Technique
Sperm source, prep and injection
Whether the sperm was ejaculated, thawed or surgically retrieved (PESA / TESA / TESE / MicroTESE), how it was prepared, and how many oocytes were injected.
- 03 Findings
Fertilisation rate and embryo development
Number of mature oocytes, normal fertilisation (two pronuclei) at 16–18 hours, and day-3 / day-5 embryo grade with any that were frozen.
- 04 Impression
Transfer, freeze and next steps
Read this first: which embryo was transferred, what was frozen for later, when to test, and whether genetic counselling is recommended.
Recognised by major UK insurers
Private medical insurance rarely covers IVF or ICSI itself. Some policies cover the diagnostic workup and the surgical sperm retrieval — we confirm cover before booking.
Frequently asked
Everything we get asked about ICSI.
Quick answers on when it helps, when it does not, cost, NHS access, surgical sperm retrieval, and outcomes for children conceived by ICSI.
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What is ICSI and how is it different from IVF?
ICSI is Intracytoplasmic Sperm Injection — a laboratory step within an IVF cycle where a single sperm is injected directly into an egg using a micropipette, rather than left to fertilise it on its own in a dish. Everything else about the cycle (stimulation, egg collection, embryo transfer) is the same.
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Who actually needs ICSI?
Severe male-factor infertility (very low count, poor motility, abnormal morphology), azoospermia treated with surgical sperm retrieval, previous complete fertilisation failure with conventional IVF, severe anti-sperm antibodies, retrograde ejaculation, and cases using very limited quantities of frozen sperm. HFEA and NICE both discourage routine ICSI where the semen analysis is normal.
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Does ICSI improve success rates for everyone?
No. For male-factor couples ICSI restores fertilisation rates to broadly the same level as conventional IVF for other couples. For couples with a normal semen analysis and unexplained infertility, meta-analyses show ICSI does not improve live-birth rates — it just adds cost and a small theoretical risk.
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How much does ICSI cost privately in the UK?
A full IVF cycle including ICSI is typically £5,000–£8,500 in London. If ICSI is added to a cycle already booked, the add-on is around £1,000–£1,500. Surgical sperm retrieval (PESA / TESA / TESE / MicroTESE) adds £2,000–£4,500 depending on technique.
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Is ICSI available on the NHS?
Yes, where the couple meets NICE and local ICB eligibility criteria (age, BMI, prior children, funding tier). Waiting times and the number of funded cycles vary a lot by area — we can help you understand where you stand.
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What is PESA, TESA, TESE and MicroTESE?
They are surgical ways to retrieve sperm when there is none in the ejaculate. PESA / MESA take sperm from the epididymis (usually obstructive azoospermia). TESA / TESE / MicroTESE take sperm from the testicular tissue — MicroTESE is the highest-yield option for severe non-obstructive azoospermia and is done under the operating microscope.
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Are children conceived by ICSI healthy?
Long-term follow-up studies are reassuring. The absolute risk of a congenital anomaly is slightly higher than natural conception (adjusted OR around 1.2–1.3), mostly related to the underlying subfertility rather than the ICSI technique. Y-microdeletions and CFTR mutations can be passed on to sons — genetic counselling is offered when this is relevant.
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Do I need genetic testing before ICSI?
It depends on the cause of the male-factor infertility. Karyotype, Y-chromosome microdeletion analysis and CFTR (cystic fibrosis) screening are commonly offered — particularly if sperm count is very low or absent, or where CBAVD is suspected. The results shape both the treatment plan and the counselling.
Related treatments
Looking for something else?
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In vitro fertilisation (IVF)
The full IVF pathway — ICSI is often a step within it.
Learn more -
Egg collection and transfer
The clinical steps around ICSI: stimulation, retrieval, transfer.
Learn more -
Donor insemination
HFEA-regulated donor sperm, when your own cannot be used.
Learn more -
Intrauterine insemination (IUI)
A simpler first-line option for milder cases.
Learn more
See also: every test and procedure we arrange.