Testicular puncture is generally used when the quality of sperm obtained by masturbation is too poor to warrant the use of this method. The quality of the sperm obtained by testicular puncture is determined by the functioning of the testicles. The quality of the sperm obtained by this method can be good or bad, and the sperm obtained is usually used for IVF or to determine the sperm production function of the testes. Since fertility cannot be achieved if you are not able to ejaculate quality semen through sexual intercourse, you can only have a testicular puncture to obtain sperm and then undergo in vitro fertilization.