Purpose : Testicular biopsy specimens contain large amounts of debris that makes sperm pickup for ICSI more difficult than with epididymal aspirates. We sought to develop improved processing techniques for testicular sperm extraction (TESE). Methods : Retrievals were with azoospermic male partner scheduled to undergo percutaneous epididymal sperm aspiration (PESA) and TESE. The study group consisted of 9 retrievals with a new TESE technique (TESE-N). The control group was 21 retrievals with PESA and 3 retrievals with a previous TESE technique (TESE-P). Results : TESE-N eliminated almost all debris, which made ICSI sperm pick-up more rapid. TESE-N, PESA, and TESE-P fertilization (77, 75, and 72%) and ongoing/delivered pregnancy rates per retrieval (67, 76, and 67%) were similar. Conclusions : Our new technique provides for easy removal of debris from TESE specimens and fertilization and pregnancy rates equal to epididymal sperm's. Eliminating debris from TESE specimens allows for rapid sperm pick-up for ICSI, making the procedure more efficient for embryology staff.