Microsurgical Testicular Sperm Extraction is the ultimate in Male Infertility. Testis is opened, a healthy chunk of testicular tissue is retrieved and sperms are looked for. In case viable sperms are located under the microscope, same are used for ICSI and spare ones are frozen for subsequent cycles. Because of my availability at the centre all the time, this procedure is very popular at ‘UROGYN’ and we accept donor semen only when possibility of using husband’s sperm is totally ruled out. Here, we score over most other centres where urologist is usually not available and as an easy recourse they go for donor semen. It makes whole lot of difference for the Intending Parents when DNA of the child born out of assisted reproductive technique matches with that of father.