Intracytoplasmic sperm injection (ICSI) has become the most commonly used method of fertilization in assisted reproductive technology. The primary reasons for its popularity stem from its effectiveness, the standardization of the procedure, which means that it can easily be incorporated into the routine practice of fertility centres worldwide, and the fact that it can be used to treat virtually all forms of infertility. ICSI is the clear method of choice for overcoming untreatable severe male factor infertility, but its (over)use in other male and non-male factor infertility scenarios is not evidence-based. Despite all efforts to increase ICSI efficacy and safety through the application of advanced sperm retrieval and cryopreservation techniques, as well as methods for selecting sperm with better chromatin integrity, the overall pregnancy rates from infertile men remain suboptimal. Treating the underlying male infertility factor before ICSI seems to be a promising way to improve ICSI outcomes, but data remain limited. Information regarding the health of ICSI offspring has accumulated over the past 25 years, and there are reasons for concern as risks of congenital malformations, epigenetic disorders, chromosomal abnormalities, subfertility, cancer, delayed psychological and neurological development, and impaired cardiometabolic profile have been observed to be greater in infants born as a result of ICSI than in naturally conceived children. However, as subfertility probably influences the risk estimates, it remains to be determined to what extent the observed adverse outcomes are related to parental factors or associated with ICSI.

胞浆内精子注射（ICSI）已成为辅助生殖技术中最常用的受精方法。其普及的主要原因在于其有效性，程序的标准化，这意味着它可以很容易地被纳入全球生育中心的常规实践中，并且可以被用来治疗几乎所有形式的不育症。ICSI是克服无法治愈的严重男性因素不育症的明确选择方法，但其在其他男性和非男性因素不育症中的（过度）使用并非基于证据。尽管已通过应用先进的精子检索和冷冻保存技术以及选择具有更好染色质完整性的精子的方法来提高ICSI效力和安全性的所有努力，不育男性的总体妊娠率仍不理想。在ICSI之前治疗潜在的男性不育因素似乎是改善ICSI结果的一种有前途的方法，但是数据仍然有限。在过去的25年中，已经积累了有关ICSI后代健康状况的信息，人们担心的原因是先天性畸形，表观遗传疾病，染色体异常，亚生育力，癌症，心理和神经发育迟缓以及心律失常等风险。因ICSI而出生的婴儿比自然受孕的婴儿要大。但是，由于生育力可能会影响风险估计，因此尚需确定观察到的不良后果在多大程度上与父母因素或与ICSI有关。