I know this is an old post, but my DH also had severe male factor issues (0% normal forms, 1-5 mil counts, very poor motility and life (both were close to the 0% range)), it was a pretty bad situation. Turns out DH has a varicocele on both testicles and had to do two surgeries to fix them, but the doctor warned us ahead of time that with numbers as low as my DH's, the surgeries were likely not to improve the numbers that much because it's likely genetic. Needless to say, the doctor was right, basically the numbers jumped from 1 to 5mil (DH's only change was drinking less and eating healthier and wearing boxers), not much change in anything else. DH's brother had no problems conceiving twice back to back though, but my DH's aunt couldn't conceive. So the whole genetic issue may not necessarily occur from one sibling to another, but I am sure that there are some fertility issues in my DH's father's side of the family that doesn't affect everyone the same way.
In any case, we were successful with both of our IVF/ICSIs, we are expecting #2 now. I'd suggest doing PGS (or CCS) testing to rule out the genetically abnormal embryos before transferring to your wife if you are worried about genetic issues. We did this for both our cycles, the first time we had only 1 normal out of 4 embryos, who is now our daughter, and this time around, we had 4 normal embryos, one of which I am pregnant with.
Just remember, with ICSI, you only need a few sperm. I remember I read that when they do a sperm analysis, they only analyze a small portion of the sample you provide, but when they do ICSI, they look at the entire sample. What you called "some machine" is the machine they use to "clean" the entire sperm sample of the bad/dead sperm so it's easier to find the good sperm to use.
Most ladies here cycle in Canada but I have cycled several times at US clinics. It will depend on what type of packing your clinic has but I think a safe estimate would be between $12K - $15K US plus your medications which would average between $3000 to $5000.
