What is azoospermia? Azoospermia is usually diagnosed clinically when no sperm can be found in the ejaculated semen on three consecutive centrifugal microscopic examinations, and after excluding non-ejaculation and retrograde ejaculation. As one of the most difficult infertility disorders to treat, azoospermia has caused deep pain to patients and numerous problems to doctors. Azoospermia accounts for about 15-20% of male infertility patients and has a wide range of causes, which can be summarized into two main categories. The first is the dysfunction of the testes themselves, called primary azoospermia or non-obstructive azoospermia; the second is the normal spermatogenic function of the testes, but due to the obstruction of the vas deferens, the sperm can not be discharged from the body, called obstructive azoospermia. Non-obstructive azoospermia (NOA) is mainly caused by testicular spermatogenic dysfunction. According to the etiology, NOA can be divided into three categories: congenital NOA (azoospermia, cryptorchidism and genetic abnormalities), acquired NOA (trauma, testicular torsion, varicocele, renal failure, inflammation, drugs, hot work, radiation and chemical injury, etc.) and idiopathic NOA (unknown cause). Obstructive azoospermia (OA) is mainly divided into congenital obstruction and acquired obstruction. Among them, the surgical damage caused by vasectomy followed by recanalization is more serious and generally more difficult to repair surgically again. Ways to obtain offspring for azoospermic couples With the development of science and technology, the possibility of obtaining offspring for azoospermic patients is also increasing. Currently, two main modalities are known: one is testicular sperm extraction (TESA) or percutaneous epididymal sperm aspiration (PESA); the removal of the husband’s sperm is combined with intracytoplasmic sperm injection (ICSI) to deliver the sperm into the egg; the other is artificial insemination by donor insemination (AID). Some studies have shown statistically insignificant differences in fertilization rates, implantation rates and clinical pregnancy rates with ICSI using husband testicular sperm and epididymal sperm. After the general diagnosis of azoospermia, a testicular puncture or epididymal puncture should be performed to diagnose the etiology of azoospermia (diagnosis of obstructive or non-obstructive). If sperm are found during diagnostic sperm retrieval, they can be frozen and preserved for later use in ICSI; if no sperm are found, AID (requiring at least one of the woman’s fallopian tubes to be patent) or donor-vitro fertilization (D-IVF) (both fallopian tubes are abnormal) can be considered. Advantages and disadvantages of various methods of fertility assistance for azoospermia ICSI enables some OA patients to obtain blood offspring, but some OA patients still choose the donor sperm treatment route (cost about 10,000 and pregnancy rate about 25%) because of the high cost of the procedure (about 40,000 and pregnancy rate about 60%) and the high technical requirements. For patients diagnosed with NOA by semen examination and testicular biopsy, although some studies have reported that sperm cell microfertilization treatment can be done, the identification and sorting of sperm cells from other spermatocytes, monocytes, lymphocytes, polymorphonuclear leukocytes, etc. is an important factor affecting their success rate, and the chromatin concentration change of sperm cells treated with this technique is a common defect. Therefore, AID has the advantages of low cost, simple technique and low invasiveness, and is easily accepted by patients, making it a common clinical treatment for azoospermia. How can azoospermia be prevented? Excluding congenital factors such as heredity, we can effectively prevent azoospermia through the following ways: 1. Regular exercise: excessive obesity in the male body can lead to an increase in temperature in the groin, which can damage the growth of sperm, leading to infertility. Therefore, weight control within the standard range can improve the quality of sperm. 2, less to sauna, steam bath: high temperature steam bath directly harm sperm, but also inhibit sperm production. 3, quit smoking and alcohol: smoking and drinking are the most important factors in the decline of sperm quantity and quality. 4, eat more green food: green vegetables contain vitamin C, vitamin E, zinc, selenium and other components that are conducive to sperm growth. 5, regular checkups: germ infection is also an important factor in male infertility and should be visited frequently by a physician, to receive examinations related to chlamydia and prostate.