When sperm count in a semen analysis is very low or completely absent, a definitive conclusion should not be drawn from a single analysis. A second analysis approximately 3 weeks later is necessary to confirm this finding. If the results are similar, advanced investigations such as genetic tests, hormone analyses, and testicular ultrasonography should be performed for a detailed evaluation. Following this stage, if deemed necessary, the patient should be consulted by an andrologist-urologist. If no sperm is found in the sample, it is possible to obtain sperm from the testicle using a surgical method called Micro TESE. Generally, the Micro TESE procedure is planned concurrently with the preparation of the woman's eggs; the obtained sperm are then used in in-vitro fertilization (IVF) applications following egg retrieval. However, in some cases, a Micro TESE operation can be performed for diagnostic purposes before the female partner is prepared. If sperm are found, they can be frozen and stored, and the female partner can be prepared later.