Azoospermia is a common cause of male infertility, and less than 5% of cases can be treated with traditional methods, so it is often considered the “incurable” form of infertility. Many azoospermia patients directly ask their doctors if they can do IVF to help them conceive, or even directly request artificial insemination. 1. True azoospermia 1. Non-obstructive azoospermia: This kind of patient is due to various causes of testicular spermatogenic dysfunction or damage, so that it cannot produce sperm, resulting in sperm not being found in the semen. Under the current medical level, most non-obstructive azoospermia treatment is not effective, however, if the gonadal axis (hypothalamus-pituitary-testes), because of insufficient gonadotropin release, resulting in small testicular development, low testosterone production, thus causing spermatogenic dysfunction, currently can be supplemented with gonadotropin to play a role in promoting male body including testicular development, and even restore spermatogenic function. 2, obstructive azoospermia: as the name implies, refers to the normal spermatogenic function of the testes, but the existence of obstruction of the vas deferens, resulting in no sperm detection in the semen. Obstructive azoospermia is usually caused by inflammation, trauma, congenital developmental abnormalities, vasectomy and other factors. If preoperative examination: no spermatozoa in semen, physical examination reveals vas deferens, epididymal sclerosis, etc., and normal serum sex hormones, it often indicates the presence of obstruction in the vas deferens. For azoospermia with a history of bilateral groin surgery, the possibility of obstruction should also be considered. Nowadays, with the improvement of medical technology, patients with local obstructive azoospermia can have their vas deferens recanalized through microsurgical techniques for the chance of natural conception. Vasectomy recanalization has the following points compared to assisted reproduction techniques: high sperm viability in semen; less genetic risk; low risk of multiple births; less physiological disturbance in women; easy psychological and emotional acceptance by patients and families; surgical trauma does not affect sexual function; low medical cost of surgery; and failure of surgery can still be taken to assisted reproduction techniques. Distinguished from traditional techniques, microscopic technology has the following advantages: avoid tissue embedding, resulting in lumen narrowing; avoid poor mucosal alignment, resulting in chronic obstruction; can do multi-layer suture, reducing the formation of seminal cysts; even in the case of mismatched tube diameter at both ends of the anastomosis, can still obtain a good anastomosis effect. However, there is still no good means of recanalization for vas deficiency. The first is that the ejaculate is not eliminated from the body along the urethra, but flows backwards into the bladder. This is a common occurrence in patients with diabetes, urethral injury, and compression of the urethra without ejaculation. It is characterized by a feeling of ejaculation, a small amount of ejaculation, and cloudy urine visible when urinating after ejaculation. Examination then reveals sperm in the urine. Solutions: Improve ejaculation habits, control diabetes, and screen sperm in urine for artificial insemination or IVF to help conception. 2. Occult azoospermia: These patients do not have no sperm in their semen, but because the number of sperm is extremely reduced, sperm can be found in the sediment after centrifugation of semen. Most of them are caused by testicular sperm production disorders. The solutions are: pharmacological spermatogenic treatment, IVF to help conception. Therefore, it is recommended that patients with azoospermia should go to a regular hospital for a comprehensive examination and then consult a professional doctor before choosing a suitable treatment plan.