Sperm extracted from testicles can be used for fertilization for men who have no sperm in their semen but want to conceive with their own gametes. The lack of sperm in semen can result from a failure in sperm production or defects in seminal ducts. If there is sperm production but the problem lies in the carrying of the sperm into the seminal fluid, sperms can be extracted directly from the seminal ducts. A TESA procedure involves a needle biopsy of the testicle in which a sample of testicular tissue is taken directly from the testis and used to extract sperm. The procedure is done either under local or general anesthesia. If enough sperm is found, it can be frozen for future use. The procedure can be repeated on the day of egg retrieval. The fertilization of female eggs with sperm extracted from the testis is only possible with the ICSI method, where one single live sperm is injected directly into each egg. Sperm extracted from the testis also enables possible conception with clients’ own gametes in a new life situation where the man has had a vasectomy but still wants a child.