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ICSI involves microscopically injecting a sperm into an ovum. Successful ICSI has become a reliable therapy for couples facing infertility, a significant milestone. However, it has also introduced various challenges. This study also delves into ethical dilemmas arising from widespread ICSI use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This review traces the history of ICSI, presenting pioneering attempts, first successful attempts, and critical reports on account of the initial skepticism toward the technology. The review also focuses on chronological progress until ICSI was recognized as effective and became widely applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main findings<\/jats:title><jats:p>The review reveals that ICSI, although transformative, presents challenges. Successes include addressing male infertility and aiding fertilization. However, concerns arise regarding optimal sperm and embryo selection, genetic mutations, and long\u2010term health implications. Ethical considerations surrounding ICSI's broad applications also surface.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite its success and effectiveness, ICSI is still evolving as a therapeutic method. By comprehensively evaluating the historical progress and the current status of ICSI and exploring its future prospects, this study highlights the importance of ICSI in infertility treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/rmb2.12582","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T12:59:58Z","timestamp":1716814798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Evolution of intracytoplasmic sperm injection: From initial challenges to wider applications"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0448-9953","authenticated-orcid":false,"given":"Yoshimasa","family":"Asada","sequence":"first","affiliation":[{"name":"Asada Ladies Clinic  Nagoya Aichi 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