Intracytoplasmic Sperm Injection (ICSI) is an assisted reproductive technique (ART) initially developed by Dr. Gianpiero D. Palermo in 1993 to treat male infertility. It is most commonly used in conjunction with in vitro fertilization (IVF) or a less commonly used technique called zygote intrafallopian transfer (ZIFT). In natural fertilization, the sperm must penetrate the surface of the female egg, or oocyte. When the male has a fertility problem such as low sperm count, malformed sperm shape, or sperm immobility, there is a significant decrease in the chance a healthy sperm will penetrate the outer surface of the oocyte. Other fertility problems ICSI can be used to overcome include the sperm having trouble attaching to the egg or the male having a blockage in his reproductive tract preventing normal ejaculation. In this procedure, the physician first obtains the sperm and oocytes from the male and female and then manually injects the sperm through a needle into the oocyte to fertilize it in an injection plate. The physician then places the fertilized egg into the female s uterus for implantation, following IVF procedures.