For couples who have a significant male factor as part of their infertility problem, in vitro fertilization combined with intracytoplasmic sperm injection (ICSI) is often their best option for achieving pregnancy. When IVF with ICSI is performed, the recovered eggs are singly injected with sperm using a microscopic glass needle. This helps ensure the highest fertilization rates possible. If a semen sample has a low count, poor movement, or poor shape, ICSI is performed. ICSI may not be required if the semen sample is normal.