Clinical interest in the fertilizing capacity of epididymal and testicular and testicular sperm originally developed from cases of obstructive azoospermia that could not be corrected surgically. We studied whether testicular sperm extraction (TESE) in obstructive azoospermia could yield spermatozoa that would result in successful fertilization and pregnancy using intracytoplasmic sperm injection (ICSI). From September 1995 until July 1996, 8 couples (12 cycles) suffering from azoospermia underwent TESE and ICSI. The mean age of husbands was 37 years (range 26 occurred in 87 oocytes (61.3%). Eleven cycles underwent embryo transfer, with a total 75 embryos (86.2%) transferred. Six cycles conceived with clinical pregnancy rate of 50.0% per cycles. So far, four healthy babies (two twin) have been born. When epididymal spermatozoa cannot be retrieved, a testicular sperm extraction can be performed and the few barely motile spermatozoa thus obtained can be used for ICSI.