Mr. and Mrs. Xiaolin are newlyweds and want to have a baby, so they came to the hospital for a full body checkup, and the husband Xiaolin was found to be spermless, so the couple was dumbfounded, how can they do this? Can not have children? The couple was dumbfounded, what can they do? There are many different opinions on the Internet, but it is most reliable to consult a doctor, so they came to Dr. Wang’s clinic. The couple was anxious when they arrived at the clinic and wanted to be cured immediately, but Dr. Wang said they couldn’t be in a hurry! Xiao Lin had only one semen analysis and was found to be azoospermic, while azoospermia refers to three consecutive semen centrifugal microscopic examinations without sperm, as well as the need to exclude non-ejaculation and retrograde ejaculation before the diagnosis can be confirmed. Dr. Wang also suggested that Xiao Lin do semen analysis at our hospital because the testing equipment and technical level of each hospital are different and the results produced may be biased. I. If azoospermia is diagnosed, there are also two types: obstructive and non-obstructive azoospermia. 1. Obstructive azoospermia: The obstruction mentioned here refers to the obstruction of the passage from sperm production to discharge from the body, i.e. the reproductive tract. The obstruction prevents the sperm from reaching the outside of the body, while a large number of sperm are present at the distal end of the obstruction. These patients often have a good sperm production function and can expect to have natural fertility after the obstruction is removed. 2. Non-obstructive azoospermia: a type of hypospermia that excludes the above-mentioned obstructive factors, such patients cannot produce sperm or produce only a very small amount of sperm, resulting in no sperm being found in the semen. Is it obstructive or non-obstructive azoospermia? The final diagnosis of obstructive or non-obstructive azoospermia may be confirmed by epididymal/testicular aspiration and testicular biopsy pathology. 1. If a large number of spermatozoa are found by epididymal puncture, the diagnosis of obstructive azoospermia can be confirmed. After congenital bilateral vas deficiency is ruled out, further surgical treatment can be considered to release the obstruction. For epididymal obstruction, we can release the obstruction by microsurgical epididymal-vas deferens anastomosis; for obstruction of the scrotal segment of the vas deferens including vasectomy, we can release the obstruction by microsurgical vas deferens-vas deferens anastomosis; and for obstruction of the ejaculatory duct opening, we need to open the ejaculatory duct opening through the urethra to release the obstruction. 2. If the testicular puncture fails to find sperm, further testicular biopsy is required. If the number of spermatozoa found in the biopsy tissue is low, only 1 to 2 spermatozoa are found in every 10 high-powered fields of view under the microscope, then it can be initially considered as low spermatogenic function and needs to be diagnosed together with the pathology of the biopsy. The common pathological types include hypospermatogenic, spermatogenic blocked, and supportive cell only syndrome. The so-called support cell only syndrome refers to the inability of the patient to produce sperm due to the absence of spermatogenic cells in the testicular tissue, which is the most serious type of azoospermia. Third, what is the ultimate treatment for non-obstructive azoospermia? The advent of intracytoplasmic sperm injection (ICSI, commonly known as second-generation IVF) treatment has allowed many otherwise infertile fathers to obtain their own offspring. Theoretically, the technique can be accomplished with the presence of a single sperm. For patients with non-obstructive azoospermia, the most advanced testicular dissection microscopic sperm retrieval procedure is used to locate the possible presence of sperm under a 20x surgical microscope, just like searching for an oasis in the desert. These precious sperm are further frozen and preserved for subsequent ICSI treatment after grinding and sperm retrieval by an experienced testing technician. Microscopic sperm retrieval has an overall efficiency of 50-60% and is currently only available in a very few medical institutions in Shanghai, such as Renji Hospital – Shanghai Institute of Male Science. The above analysis of the azoospermia, male friends once checked out azoospermia must not panic, according to the requirements of the doctor step by step examination, through the latest medical technology as long as a sperm is found there is still a possibility of fertility!