Some experts state, “The only way for azoospermia patients to have children is in vitro fertilization or to give up treatment.” Is this really the case? Of course the answer is no, no! No, the truth is: there are still many chances and hopes! Azoospermia is a common type of male infertility, according to epidemiological surveys, the prevalence of normal male population is close to 1-2%, which means that among 100 men, 1-2 people are azoospermic, of which 20% belong to obstructive azoospermia and 80% are non-obstructive azoospermia. Among obstructive azoospermia, epididymal obstruction accounts for 30-67%, which can be surgically recanalized through microscopic vasovaginal epididymal anastomosis with a success rate of 80%; vasovaginal medical obstruction accounts for 2-6%, which can be surgically recanalized through microscopic vasovaginal anastomosis with a success rate of 75-99%. Comprehensive data of obstructive azoospermia, microscopic anastomosis may lead to recanalization of the seminal tract in nearly 70% of patients! In non-obstructive azoospermia with combined varicocele, if microscopic sperm ligation is performed first, sperm may be present in the semen 1 year after surgery in nearly 40% of patients, 60% of these patients can conceive spontaneously, and the remaining 60% can obtain sperm for ICSI or IVF by microscopic testicular sperm retrieval; if there is no combined varicocele, microscopic testicular In the absence of combined varicocele, microscopic testicular sperm retrieval can help 60% of patients to obtain sperm, 40% of which can be used for ICSI or IVF. Overall, microscopic surgery can eventually help 2/3 of patients with difficult to treat azoospermia, so patients with azoospermia should be evaluated by a urologist familiar with microscopic surgery before treatment options are determined, rather than directly “test tube” or “give up”! It is not just “test tube” or “give up”!