Sperm extraction and manual sperm injection are not normally done together. Sperm gathered straightforwardly from the testis or epididymis is not "develop" enough to swim and treat the egg. Just if the sperm was extricated from the vas deferens, the sperm might be develop enough for manual sperm Azoospermia (https://cdn.elawoman.com/posts/bfd0383f9ede36b89549f57d578c3248.jpg) .
By definition, azoospermia treatment (https://www.elawoman.com/blog/fertility-treatments/what-is-pesa-treatment) means that a man does not have a measurable measure of sperm in his seme
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