There are certain cases where sperm is not present in ejaculation. Possible reasons for this could be the congenital absence of the vas deferens, problems with ejaculation, inflammation due to mumps virus, etc. Individuals with this problem face difficulty in having children. Thanks to technology, it is now possible for these men to have children.
This is achieved by performing the percutaneous epididymal sperm aspiration (PESA) or testicular epididymal sperm extraction (TESE) to obtain the sperm directly from the testis for ICSI. From the collected specimen a single sperm is extracted to be inserted into the egg.
It is a highly recommended procedure with very good success rates.