A subset of patients with azoospermia is treatable: central hypogonadotropic hypogonadism; hyperprolactinemia due to pituitary tumors; varicocele; low cryptorchidism (testicular biopsy with sperm cells); obstructive azoospermia. A part of the treatment is long and has a poor prognosis: microtesis (testes less than 6 ml) with increased FSH LH. A part of azoospermia (testis less than 2ml, FSH LH more than 2 times higher, testis only support cell syndrome, some sex chromosome disorders, such as 46,xx) is of no therapeutic value. I. Endocrine treatment 1. Endocrine examination of blood FSH, LH is significantly lower than normal, indicating hypogonadotropic hypogonadism, which can be treated by applying hCG or hMG. 2. Patients with hyperprolactinemia can be treated with bromocriptine. If the prolactin is too high, nuclear magnetic examination should be done to see if there is a pituitary tumor, and if the azoospermia is caused by hypothalamus or pituitary tumor, radiotherapy or surgery should be done for this. Second, the Chinese and Western medicine treatment can be used some estrogen inhibitors: clomiphene, tamoxifen; vitamin C, E; trace elements: zinc, selenium, etc.; spermogenic Chinese medicine or proprietary Chinese medicine. Third, the treatment of varicose spermatozoa Check is azoospermia caused by varicose spermatozoa, in principle, can be treated by surgery. Before doing the surgery, testicular biopsy examination is needed to determine the degree of testicular damage, which can determine the recovery of testicular spermatogenic function after spermatozoal vein high ligation. If the testicular biopsy shows that the testicle is severely damaged and irreversibly damaged, then the procedure is not necessary. If the damage of the testicle is mild, there are good results after the surgery. Treatment of cryptorchidism Surgery is recommended before the age of 2. The later the surgery, the greater the impact on fertility. For low cryptorchidism (testicular biopsy with sperm cells), endocrine therapy should be provided after surgery. V. Treatment of vas deferens and epididymis If the testicular biopsy is normal, the cause of azoospermia is considered to be caused by blockage of the vas deferens, which can be treated surgically. 1. For patients who have had male tying, it is very clear that it is a blockage of the vas deferens, and there is no need to do testicular biopsy examination. For this treatment, male vasectomy is needed, and this surgery is a microsurgical method to connect the vas deferens bilaterally, and the recanalization rate is over 90%. 2.The vas deferens caused by blockage of epididymis. In this regard, epididymal exploration and microscopic vas deferens epididymal anastomosis should be performed. Testicular and epididymal puncture + testicular tissue, sperm freezing + second generation IVF, i.e. intracytoplasmic sperm injection (ICSI) This is an assisted reproduction technique, which requires testicular puncture for sperm extraction, epididymal puncture for sperm extraction, intracytoplasmic sperm injection (ICSI), freezing, incubation and transplantation techniques. Seven, testicular microsperm retrieval + ICSI or donor sperm IVF: Indications: 1, for those who have not found sperm by testicular puncture, except for those with pathology of only supporting cell syndrome; 2, testes greater than 2 ml, FSH less than 2 times; 3, kernicterus (47, xxy), or Fernando (47, xyy); microsperm retrieval surgery, for those who have determined in the past that no sperm can be found (such as azoospermia after testicular epididymal puncture ) who have another 30% hope, also have the thought of not finding sperm and outlet options (adoption, donor sperm).