Most of the IVF clinics abroad will opt for ICSI as the primary choice for fertilising eggs, even when the semen analysis is normal. The reason for this is that conventional IVF (where a volume of sperm is placed in the same dish as the eggs and left to fertilise naturally) can potentially lead to a failure to fertilise. This would be a poor outcome if you had travelled a long way for treatment. Some clinics may offer half conventional and half ICSI if there are sufficient eggs. There has been concerns in the past about whether ICSI was responsible for an increase in some abnormalities in children conceived using this technique. So it is worth engaging in a discussion with the clinic if you have any specific concerns in relation to ICSI.
WHO (World Health Organisation) have outlined the reference values for what is considered a normal semen analysis following revision in 2010.
Semen volume (ml): 1.5
Total sperm number (million per ejaculate): 39
Sperm concentration (million per ml): 15
Total motility (Progressive and Non-progressive, %): 40
Progressive motility (%): 32
Vitality (live spermatozoa, %): 58
Sperm morphology (normal forms, %): 4
Your embryologist will be in a position to advise you of the most appropriate technique to use. Sometimes they might suggest IMSI. IMSI can give the embryologist a better view of individual sperm and so, although it costs more, for samples with very few normal sperm, this technique may increase your chances of a normal pregnancy. Find out more about IVF techniques.