Current and future perspectives on intracytoplasmic sperm injection: a critical commentary.

Intracytoplasmic sperm injection (ICSI) is an increasingly popular means of treating infertility in couples who wish to conceive. However, there are many potential complications that can be faced by the clinician while performing ICSI. These complications and other related issues are discussed, with an emphasis on understanding how these issues are being resolved, or how they can be resolved in the future. Matters of sperm selection and injection are discussed, as well as the effect of ICSI on fertilization, embryonic growth and development, and the health of ICSI-conceived children. These aspects are viewed from various perspectives, including genetic, mechanistic, developmental and clinical. Since new studies on ICSI are published regularly, it is important that the established protocol is revised often, and that the role of ICSI in infertility therapy is continually re-evaluated.