Among couples presenting for treatment at the IVF unit because of male infertility, some male partners have no sperm at all in their ejaculate (a condition called azoospermia). Fortunately, in most of these men sperm may be found in the testicle, where sperm are synthesized. These sperm can fertilize an oocyte if directly injected into it using the ICSI technique.

Until this method was developed, such men were considered infertile and could not father children of their own. Today, about 40 couples a year conceive with the assistance of TESE and ICSI at our medical center. The extraction procedure is performed by andrologists at the male fertility institute, under local anesthesia. Testicular tissue is submitted to the IVF lab where it is scanned under a microscope and sperm is extracted. Usually, there is a small number of sperm in such a tissue sample, and some of them lack the capacity to move forward. Thanks to the ICSI technique, only one sperm is needed to fertilize each oocyte, and in most cases fertilization does occur with the development of an embryo. The unit is very experienced with this method, and the chances of conception are high.

The microphotograph shows a single spermatocyte (circled in red) among many other testicular cells. Such a spermatocyte, injected into the female partner's oocytes, has excellent chances of fertilizing it and producing an embryo.