(ROSNI) Experimental form of testicular sperm extraction (TESE) followed by intracytoplasmic sperm insertion (ICSI) in which the nucleus of a round (very immature) spermatid is isolated for injection into the egg (or secondary oocyte). Intended to be used in treating non-obstructive azoospermia with severe maturation arrest, when more spermatozoa are not obtainable. Animal studies show higher pregnancy rates than with round spermatid injection (ROSI), but limited studies in humans still indicate very high rates of embryopathy. Not recommended clinically.