Esteves SC, et al. - The sperm DNA fragmentation (SDF) levels between testicular and ejaculated sperm underwent a comparative analysis. This study also assessed the outcomes of intracytoplasmic sperm injection (ICSI) with the use of testicular (Testi-ICSI) versus ejaculated (Ejac-ICSI) sperm in nonazoospermic men with high SDF. Lower levels of SDF were found in the testicular sperm than the ejaculated sperm, with Testi-ICSI for high post-testicular SDF men improving reproductive outcomes compared with Ejac-ICSI. The results suggested that the infertile couples could gain an advantage from Testi-ICSI if male partners reported affirmed high SDF in the ejaculate.