With aspiration of sperm directly from the epididymis (MESA) or extracted from the testis (TESA) and intracytoplasmic sperm injection, it is possible to provide men who are incapable of producing viable sperm in an ejaculate the ability to overcome this severe sperm defect and produce a successful pregnancy. In our practice, 10 of 26 ART cycles have had successful pregnancies with a total of 17 children being delivered. Thus, MESA/TESE techniques coupled with ICSI provide this population of patients with a viable option for producing offspring.

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