Sperm is a necessary weapon for men to show off their masculinity, but if there is no sperm in the semen, it may make men feel “hopeless” at first sight. Fortunately, medical advances nowadays, even if azoospermia occurs, it is still possible to take out the sperms through testicular microscopic examination, and then through IVF technology, it is possible to give birth to a child successfully, bringing a ray of hope. First, what is azoospermia Normal male ejaculate volume of about 2 to 5 milliliters of semen at a time, and semen is grayish-white to slightly yellow, viscous liquid, semen is composed of spermatozoa and liquid. When the semen does not contain any sperm, it is called azoospermia. Azoospermia can be categorized into obstructive and non-obstructive types: 1. The first obstructive type: it means that the testes can produce sperms normally, but they cannot be transported to the semen. Microsurgery techniques can be applied to find the blockage point and connect the vas deferens microscopically; if it is not possible to connect the vas deferens or due to the factors of the spouse (e.g., older age), sperms can be removed from the testes or epididymis directly to carry out IVF. 2. 2. The second type of non-obstructive azoospermia: a problem with the sperm-making process in the testes. Non-obstructive azoospermia means that the testes are not functioning well and cannot make sperm or only make very few sperm. Since sperm cannot be obtained by normal testicular or epididymal sperm retrieval techniques, this is the most challenging part of male infertility. In this case, more precise testicular microscopic examination and microscopic sperm retrieval techniques are needed to obtain sperm for IVF artificial reproduction treatment. Testicular microscopic examination After statistics, the fertilization rate of non-obstructive azoospermia patients who used testicular microscopic examination and microsperm retrieval to obtain sperm for IVF was 77.52%, and the rate of sustained pregnancy at more than 24 weeks was 36.8%, which is comparable to the rate of 74.50% and 39.7% for obstructive azoospermia who used testicular microsperm retrieval and IVF, and the sustained pregnancy rate for the first half of 2015 rose again to the rate of 74.50% and 39.7% for obstructive azoospermia, which was comparable to that of 74.50% and 39.7% for testicular sperm retrieval and IVF. pregnancy rates rose again in the first half of 2015 to 41.2% for obstructive and 50% for non-obstructive. In other words, as long as sperm are available, men with azoospermia have almost the same pregnancy, ongoing pregnancy, and live birth rates regardless of whether their azoospermia is due to obstructive or non-obstructive causes. For non-obstructive azoospermia, the microtesticular sperm retrieval has a chance of obtaining sperm for most of the azoospermia patients, and together with the IVF technique, there is a chance of having a baby. Diagnostic Microdissection-TESE Diagnostic Microdissection-TESE consists of the first part of microdissection-TESE and the second part of microdissection-Micro TESE. In the first part of microdissection-TESE, the patient is placed under general anesthesia, and the testes are sequentially divided through an incision of approximately 4-5 centimeters in the middle of the scrotum. The testes are then incised through the leucomastoid membrane in the central axis of the testes, and under the guidance of a surgical microscope, the testes are examined to look for fine spermatic tubules with a diameter of more than 300 μm (where spermatozoa are hidden), and the location of the tubules is marked, and the wound is closed, so that in the future, in conjunction with his wife’s egg retrieval surgery, the patient can undergo microtestis sperm retrieval (the second part of the microtestis sperm retrieval surgery). This not only greatly shortens the operation time, but also increases the chance of success of the operation. However, this method is rarely used nowadays as sperm freezing and recovery techniques have become more sophisticated due to the secondary surgical injuries it causes to the patient.