A surgical procedure used to collect sperm from a man when ejaculation is not possible or when sperm does not reach the ejaculate. Sperm extraction is used in men who have a structural abnormality or an obstruction of the vas deferens, the tube through which sperm move during ejaculation. It is sometimes performed after a vasectomy or after a failure to reverse a vasectomy. Before the procedure, the man may have general anesthesia, but usually a local anesthetic is used. Seminal fluid containing sperm is removed either with a tube or a needle through an incision. Alternatively, a needle biopsy directly from the testicles is obtained, and sperm cells are recovered. The sperm is then treated and prepared for ICSI (intracytoplasmic sperm injection) and in vitro fertilization.