Purpose <p>Men with low capacitation ability have reduced conception through intercourse, IUI, and conventional <i>IVF</i> and are often referred for ICSI. This study evaluated whether reduced capacitation ability, as measured by Cap-Score, impacts ICSI outcomes.</p> Methods <p>Retrospective review of 199 men undergoing ICSI at a single clinic (2018–2023). Semen analysis included Cap-Score. Fertilization and euploidy rates were compared for low vs normal Cap-Scores and abnormal vs normal semen analyses. Following frozen embryo transfer, Cap-Scores and semen analysis outcomes were compared between positive and negative pregnancy indicators. Multiple and logistic regression assessed whether male and female factors, including Cap-Score, independently predicted fertilization, euploidy, hCG positivity, or clinical pregnancy.</p> Results <p>Fertilization (82 ± 1.9 vs 80 ± 1.6%; <i>p</i> = 0.40) and euploidy rates (43 ± 5.1 vs 34 ± 3.3%; <i>p</i> = 0.13) were similar for those with low vs normal Cap-Scores. Cap-Scores did not differ for negative vs positive hCG (30 ± 1.2 vs 30 ± 1.0%; <i>p</i> = 0.96), clinical pregnancy (30 ± 1.0 vs 30 ± 1.1%; <i>p</i> = 0.83), or ongoing pregnancies/live birth (30 ± 1.0 vs 30 ± 1.1%; <i>p</i> = 0.92). Fertilization and pregnancy outcomes were independent of semen analysis results. Multiple regression showed fertilization was associated only with female age and number of oocytes retrieved (<i>R</i>² = 6.8; <i>p</i> = 0.002), and euploidy with female age and percent sperm motility (<i>R</i>² = 24.5; <i>p</i> &lt; 0.001). Logistic regression showed no independent association between Cap-Score and hCG (<i>R</i>² = 6.18; <i>p</i> = 0.054) or clinical pregnancy (<i>R</i>² = 5.28; <i>p</i> = 0.032).</p> Conclusion <p>Within this cohort and analytical framework, no association was detected, supporting the conclusion that men with low Cap-Scores can be counselled that their ICSI outcomes are comparable to those with normal scores.</p>