Chronic renal failure, dialysis and immunosuppression after transplantation may cause varying degrees of reproductive failure in both females and males. Although transplantation may reverse most of sperm functions in the male, there is sufficient evidence in the literature that sperm motility may not be restored. In such cases, Intra-cytoplasmic sperm injection (ICSI) may be considered. We presented three male factor cases with renal transplantation in whom 2 had pregnancies by ICSI procedure. There is no report in the literature for use of ICSI in couples in which the infertile husband had renal transplantation. Case 1 was a 25-year-old woman with infertility of 7 years. Her infertility work-up was normal. The husband, 33 years old, had renal transplantation 1 year ago. His sperm analysis showed asthenoteratospermia (42 million/ml, 12% progressive motility, and 0% normal morphology). The wife underwent ICSI procedure with long luteal protocol. Nine oocytes were retrieved and 8 pronuclear oocytes (PN) were formed. Three embryos with 8 cells, 8 cells and 6 cells were transferred. She delivered healthy twins at 36 weeks of gestation. Case 2 was a 34-year-old woman with infertility of 6 years. Her infertility work-up was normal. Her husband, 34-year-old, had renal transplantation 2 years ago. He had oligoasthenoteratozospermia (2.2 million/ml, with 0% progressive motility). He used cyclosporine, prednisolone for immunosuppression and diltiazem for hypertension. He was hospitalized for a mild episode of chronic rejection during IVF treatment. The wife underwent an ICSI procedure. Four oocytes were retrieved and 3 PN were formed. Two embryos with 8 cells and 10 cells were transferred. She is currently 20 weeks pregnant for a singleton. Case 3 was a 31year-old woman with a previous spontaneous abortion and applied after 3 years of failure to conceive. Her diagnostic work-up revealed only a subtle decrease in her serum protein S levels. Her husband, 41-years-old, had renal transplantation 16 years ago, but he was currently in chronic renal failure with continuous ambulatory peritoneal dialysis. His sperm analysis showed oligoasthenoteratozospermia (8.2 million/ml, 0% normal morphology, and % 0 progressive motility. She underwent ICSI procedure and 4 oocytes were retrieved, 3 were fertilized and two embryos (8 cell and 10 cell) were transferred. However, pregnancy did not occur. Conclusion: Health status after renal transplantation influences the sperm functions even for ICSI. Because sperm is required for fertilization and embryonic development, ICSI candidates after renal transplantation must be at the optimum health condition.