Management of obstructive and non-obstructive azoospermia by intracytoplasmic sperm injection following Percutaneous Epididymal Sperm Aspiration (PESA) or Testicular Sperm Aspiration (TESA) The injection of a single sperm directly into the center of an egg (ICSI) has now become the treatment choice for couples with a severe male factor. Pregnancy is prevented because poor sperm lack the progressive motility required to break through the outer membrane of the egg (zona pellucida) to achieve fertilisation. We Care’s partner fertility centres have performed over 4000 ICSI procedures. Only 7% of patients fail to achieve fertilisation. The first babies were born in 1994, and since then many healthy babies have followed.