In the current era of assisted reproductive techniques where technology can help overcome defects in sperm function, the value of semen analysis has become even more inaccurate. Initial reports of intracytoplasmic sperm injection revealed its ability to bypass the natural selection process and enable men with severely impaired semen parameters to achieve both clinical pregnancy and live birth

Inclusion Criteria:

1. Infertile male patients with abnormal semen parameters.
2. Normal female partner aged <38 years.

Exclusion Criteria:

1. Female patients with obvious infertility factor.
2. Male patients with azoospermia.
3. Male patients with systemic diseases.
4. Male patients receiving cytotoxic therapy.
5. Male patients with genital pathology as cryptorchidism.

The study will include all infertile couples undergoing intracytoplasmic sperm injection in The Department of Dermatology and Andrology with assisted reproductive unit at women's health hospital, Assiut University Hospital.