Genomics, transcriptomics and proteomics study candidate genes, transcripts and proteins involved in sperm development, acrosome reaction and fertilization. Determination of ROS and sperm apoptosis markers, i.e. mitochondrial membrane potential, membrane translocation of phosphatidylserine and DNA denaturation/fragmentation provides information on sperm function. Testicular spermatogonial stem cell cultures will enable restoration of spermatogenesis defects. For ICSI, sperm is selected by density gradient centrifugation and swim-up preparation, The hyaluronic acid binding identifies mature sperm. Magnetic-activated cell. sorting using annexin V-conjugated microbeads, the zeta method and the electrophoretic filtration eliminates apoptotic sperm. High magnification pen-nits selection based on sperm head vacuoles. After testicular sperm extraction, the use of motile and/or frozen-thawed sperm influences blastocyst development positively. Sperm selection after high magnification develops new insights in pathophysiology and improves ICSI outcome.