If there are no sperms (Azoospermia) in the ejaculate as well as after TESA (Testicular sperm aspiration), we cannot perform an ICSI . The only chance to achieve a pregnancy is the use of donor sperm for heterological insemination.
That means the process of inseminating a woman with sperm obtained from a sperm donor. The sperm of the especially tested donor is usually obtained as a frozen specimen from a sperm bank. Intrauterine insemination is usually recommended because studies have shown that the chances of successful conception are higher if timing of exposure to sperm is controlled, and if sperm is placed in higher numbers closer to the egg or eggs.