The direct injection of sperm into the eggs obtained after ovum pick up frequently permits the establishment of pregnancy in even the most difficult types of male infertility including men who have fewer than 100 sperms in their semen. In patients who have no sperms in the semen sample because of vasectomy, blocked ducts, failure to ejaculate because of spinal cord injury, non obstructive azospermia and conjenital absence of Vas a non surgical sperm aspiration (TESA/PESA) is performed. (TESA/PESA) is an easy and quick method to obtain adequate number of sperms for ICSI. (TESA/PESA) is performed under sedation and is painless and rapid. A tiny needle is used to extract sperms directly from the testis. Aspiration of 100/200 sperm by TESA/PESA is enough to achieve pregnancy when combined with ICSI.

A mature metaphase II oocyte with the polar body visible at 12 O'clock position	The sperm is gently advanced forward towards the pipette tip and the pipette is slowly and steadily inserted through the zona pellucida
The intack oolemma apparent by the invagination around the micropipette
The microinjection pipette is slowly withdrawn out of the egg as gently as possible making sure that the sperm remains inside	The microinjection pipette has been completely withdrawn from the oocyte

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