Objective: To describe a simple injection apparatus and method for per
forming intracytoplasmic sperm injection in a clinical IVF program. De
sign: A prospective clinical trial of intracytoplasmic sperm injection
. Setting: A private office-based fertility program. Patients: Five co
uples undergoing IVF-ET with intracytoplasmic sperm injection as a tre
atment for male factor infertility. Interventions: Intracytoplasmic sp
erm injection was performed at room temperature (23.5 to 24.5 degrees
C) in a simple zwitterion-buffered medium. Main Outcome Measures: Fert
ilization rates, cleavage rates, clinical pregnancy rates, implantatio
n rates. Results: Intracytoplasmic sperm injection was performed on 44
fresh oocytes from five patients. Twenty-three oocytes fertilized (52
.3%) and 22 zygotes cleaved (95.7%). Three of five patients became pre
gnant (60%), resulting in the live birth of one normal male infant, on
e continuing singleton pregnancy, and one continuing twin gestation (4
6XX, 46XY). The implantation rate was 23.5%. Conclusion: Intracytoplas
mic sperm injection can be performed successfully in a simple medium a
t room temperature using commercially available microtools.