Unlike non-obstructive azoospermia, patients with obstructive azoospermia have normal spermatogenesis, so sperm can be retrieved by testicular puncture and therefore IVF can be done through puncture for sperm extraction. Therefore, there are two options for such patients who want to have a child: microsurgery and IVF, how should they choose? To do surgery or IVF, the doctor will communicate fully with the patient, but of course if the assessment can achieve surgical recanalization, surgical treatment is still recommended. 1.Surgical treatment of obstructive azoospermia is aimed at treating the cause of male infertility, and men recover quickly after surgery, and it does not cause damage to women; while IVF is mainly operated on women – the process of ovulation promotion with drugs, egg removal, fertilized egg transplantation, etc., and the pain is definitely greater. 2. Natural conception can be achieved after surgical recanalization, and the most “healthy and strong” sperm is selected by natural selection; whereas the sperm for IVF is randomly obtained by testicular puncture and cultivated in the laboratory for insemination. In other words, the fetus produced by natural conception after surgical recanalization is completely natural. 3.With the liberalization of the two-child policy, it is not difficult for patients who successfully conceive after surgery to have a second child, but having a second child in an IVF family means continuing to do IVF. 4.The price of microsurgery is relatively low, around 15,000 yuan, and the success rate of recanalization is 70~80%, while it costs about 30,000 yuan to do IVF once, and the pregnancy rate is around 50% if the woman is not too old. Of course, not all patients with obstructive azoospermia can be treated surgically. If the obstruction is not located in the epididymis, then the probability of recanalization after surgery is very low and surgery is not recommended; if the female partner is older, for example, above 35 years old, IVF is recommended in order to get pregnant as soon as possible, even if the success rate of surgery is assessed to be higher in the male partner; some obstructive azoospermia also has a certain degree of heredity, such as patients with vas deficiency and seminal vesicle deficiency, and such patients have to undergo third generation IVF, through genetic screening, to avoid the recurrence of the same condition in offspring boys.