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Severe male infertility can be a difficult condition to manage. When rare sperm are present in the ejaculate, the management of such samples and couples who have this condition is not well understood by many reproductive experts, even IVF doctors themselves. In this video, an internationally recognized male infertility expert, Dr. Peter Schlegel, provides insight into what a semen analysis means when it is reported as showing "Azoospermia", but additional processing of the semen specimen shows rare sperm. This finding is often misunderstood by the best IVF doctors, and reproductive urologists as well. Dr. Schlegel explains how this condition can be further evaluated, and how surgery can be coordinated with IVF to provide the best chance of using sperm from the ejaculate and getting the best results with IVF in severe male infertility. Watching this video has a chance of avoiding unnecessary surgery for men with severe male factor infertility. Learning from the experts who coordinate care in severe male factor is critical to obtain the best results in your infertility care. microTESE surgery can be very effective for men with azoospermia who absolutely need it, but avoiding surgery when there is a chance of obtaining rare sperm from the ejaculate is equally important to give couples the best chance of treatment success.