These methods are performed in cases of azoospermia, due to obstruction or non existence of vas deferens (the tube that connects the testis to the penis), or reduced sperm production by the testis.

In such cases, sperm is collected after testicular biopsy (TESE), or transdermally with topical anesthetic from epididymis or the testis (MESA). These procedures can be very effective when combined with ICSI.

In using these methods, male factor infertility can be overcome (90% success rate).