The successful fertilization of clinical pregnancies resulting from the injection of a single spermatozoon into the oocyte (ICSI) which started a new era in the field of assisted reproduction. This technique is performed in cases of severe male infertility and combination with MESA, PESA or TESA.  
 
There is no evidence to date for any significant increase in the rate of major congenital malformations in children born after ICSI.