This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous (Obs), Subject name: Gynaecology & Obstetrics
True statement regarding procedure shown below is: 
Select and explain. 
A. Done routinely with IVF, B. Risk of congenital anomaly is lower as compared to IVF alone, C. Performed when sperm count is <5 million/ml, D. Sperm preparation is not required
C: Performed when sperm count is <5 million/ml
Answer: C: Performed when sperm count is <5 million/ml 
Explanation: Ans. C. Performed when sperm count is <5million/mlICSI is not done routinely. It stands for Intracytoplasmic Sperm Injection: single sperm is introduced inside a single ovumIndications for ICSI:a. Previous failed IVFb. Sperm count <5million/ml or <5% progressive motility or <4% normal morphology as in a case obstructive azoospermia or primary testicular failure. In these cases, sperms are obtained from either the epididymis or testis itself.c. In case of severe oligospermia or azoospermia, the sperms are obtained by TESE (Testicular sperm Extraction) and sperm preparation is required as in conventional IVF.A higher congenital anomaly rate is there with ICSI (4.2%), as compared to conventional IVF (2-3%)