Men with Sertoli only syndrome may still have pockets of normal sperm production. In approximately 33-50% of cases we are able to find some sperm in men with Sertoli only syndrome (sufficient for IVF or ICSI). Typically in cases like this though I almost universally recommend going on a medicine such as Clomid for at least three months followed by a microscopic testicular sperm extraction. Because this has to be done under anesthesia and can take several hours the costs of the procedure typically range from $3,000-$12,000.