Some couples will need to proceed to assisted reproductive techniques such as in vitro fertilization, or IVF. In some male patients, sufficient sperm are not available in the ejaculate. This deficiency may be due to problems with sperm production, obstruction of the male reproductive tract, or disorders of ejaculation. Therefore sperm retrieval techniques must be employed to obtain sperm for use in IVF.

The type of procurement technique used depends largely on the nature of the patient's problem. If obstruction or ejaculatory disturbance is the primary issue, epididymal sperm retrieval is the preferred method. This typically will yield motile, mature sperm. If the problem is one of abnormal sperm production, then removal of a small amount of testicular tissue and extraction of sperm is the usual procedure.

Sperm obtained by these techniques are injected directly into the egg, in a process known as intracytoplasmic sperm injection, or ICSI. Only one live sperm is needed for each egg. Often, sperm obtained via procurement techniques can be used fresh in IVF procedures or cryopreserved and used at a later date.