The invention of Intracytoplasmic Sperm Injection (ICSI) has revolutionized the treatment of male infertility, by achieving high rates of fertilization in patients who previously would have had little hope of conceiving. Treatments advocated in the past for male infertility such as Clomiphene, gonadotropin injections, hCG injections, and/or ligation of a varicocole have less of a role in the era of ICSI. Patients with previous vasectomy, especially greater than 10 years, are at great risk of forming antisperm antibodies and should also be treated with ICSI. Even certain patients with complete absence of sperm in the ejaculate may be able to father their own children through a simple procedure, in which sperm is extracted directly from the testicle, called Testicular Sperm Extraction (TESE).