Before the era of intracytoplasmic sperm injection (ICSI),few options were available for men with severe infertility to father a biological child.Introduced in 1992 as a modification of conventional in vitro fertilization,ICSI has enabled men with low sperm quantity and quality to have their own biological offspring.1 Among nonazoospermic infertile men,ICSI has been traditionally carried out with ejaculated sperm.By contrast,methods to harvest sperm from the epididymides and testes are used for ICSI in men with azoospermia-related infertility.