Testicular Sperm Extraction (TESE) is the process of removing a small portion of tissue from the testicle uner local anesthesia to extracting the few viable sperm cells present in that tissue for the purpose of Intracytoplasmic sperm injection (ICSI). The Testicular Sperm Extraction process is recommended to men who are unable to produce sperm by ejaculation as a result of primary testicular failure, congenital absence of the vas deferens or non-reconstructed vasectomy.