A 25-year-old married male presents with infertility. He had undergone retroperitoneal lymph node dissection at age of 15 years for embryonal carcinoma of right testis. Semen analysis shows-quantity-0.5 ml, no. sperm, no fructose. Biopsy of testis shows normal spermatogenesis. Best treatment here would be -

The absence of sperms in presence of normal spermatogenesis along with absence of fructose is suggestive of an obstruction in the ejaculatory duct.  "Sperm aspiration techniques are indicated in men in whom the transport of sperm is not possible because the ductal system is absent or surgically unreconstructable. Aspiration procedures can involve microsurgery to collect sperm from the sperm reservoirs within the genital tract (vas deferens, epididymis or testicle)" - Smith's Urology 17/e, p 710 Micro testicular aspiration of sperm with In Vitro Fertilization can help this couple to achieve pregnancy. (Intracytoplasmic injection is a form of IVF)