The ICSI with sperm of testicular origin (TESE) helps to solve cases of lack of sperm in ejaculate. Azoospermia can have an obstructive origin (such as after a vasectomy) or of secretory origin (men whose testicles do not produce sperm or produce them in a focal or marginal way).

Once a complete test has been carried out to rule out chromosomal alterations, a testicular biopsy can be performed and, if sperm is obtained, it can be used in an ICSI.

The technique is performed under local anesthesia. A small incision is made in the testicle and a sample of testicular tissue is obtained for the biologist to analyze if there are sperm. In the case of finding sperm, it can be used for an ICSI the same day of the follicular puncture or it can be cryopreserved for the future. After some stitching with absorbable material and a brief recovery period in the clinic, patients are recommended one week of light rest. Complications are rare.