Testicular sperm extraction (TESE) is recommended for men who cannot produce sperm by ejaculation. To begin, the surgeon verifies the patient’s identity against his wristband and paperwork. Next, the surgeon removes a small portion of testicular tissue, which (s)he evaluates under a microscope to locate individual sperm cells. These samples can be used fresh as part of an ICSI procedure or cryopreserved for future IVF use.