Is it permissible to perform an intracytoplasmic sperm injection (ICSI) procedure to treat infertility, given that most of these procedures are performed by male doctors, and that the wife suffers from severe ovarian insufficiency and a low ovarian reserve, which necessitates immediate intervention?

Contemporary jurists have differed regarding the ruling on intracytoplasmic sperm injection (ICSI). Some forbid it, while others permit it under certain conditions. Among the conditions set by those who permit it are: that the injection be performed by a trustworthy female doctor, that the egg and sperm be from the husband and wife, that the sperm be extracted by permissible means, and that any surplus be disposed of.

If a trustworthy female doctor is available to perform the procedure, it is not permissible for a male doctor to perform it, because a woman viewing another woman’s awrah is less severe. However, if a skilled female doctor is not available, it is permissible for a trustworthy Muslim male doctor to perform it, provided a mahram (definition) or a trustworthy woman is present to prevent khalwa (definition) (private seclusion).

The Islamic Fiqh Council has stipulated that the third method of artificial insemination, which involves taking germ cells from both spouses, fertilizing them externally, and then implanting them into the wife's uterus, is principally acceptable. However, it should only be resorted to in cases of extreme necessity, and with the fulfillment of conditions, including: that the treating physician be a Muslim woman, then a non-Muslim woman, then a trustworthy Muslim male doctor, then a non-Muslim (in this order of preference), and that there be no khalwa between the treating physician and the woman except in the presence of her husband or another woman. The couple’s need for a child is considered a legitimate purpose that permits treatment by permissible means.