
Intracytoplasmic sperm injection (ICSI) is widely used in infertility treatment, particularly in cases involving sperm motility or morphological abnormalities. In conventional ICSI, mechanical injury to the oocyte has been an issue, and Piezo-ICSI was developed as a technology to address this. Utilizing the micro-vibration of a piezo element, it punctures the egg cell membrane instantaneously, minimizing egg damage. Studies using Piezo-ICSI in animal models such as mice, pigs, and bovines have reported improved fertilization and birth rates, and Piezo-ICSI is particularly useful for creating genetically modified organisms. It is also expected to enhance breeding efficiency in the livestock industry. Recent advances have enabled the clinical use of Piezo-ICSI in humans, and higher fertilization rates and better embryo development than conventional methods have been reported, especially in older women. This article outlines the Piezo-ICSI procedure, its advantages and disadvantages, troubleshooting, and clinical outcomes based on our clinic’s experience.