Azoospermia can be diagnosed in infertile men if no sperm is detected in three semen tests. For azoospermia patients, in addition to the need for palpation to check the testicles and epididymis, laboratory tests of hormones and other items, testicular biopsy is also a very important test. Under local anesthesia, a small piece of testicular tissue is taken through a puncture needle for pathological observation, which can directly determine the function of the testis in producing sperms or the degree of obstruction in sperm production, and quantitatively evaluate the ability of the testis to synthesize hormones and the degree of obstruction, thus providing a reliable basis for the diagnosis and treatment of male infertility. If the biopsy reveals sperm and the spermatogonial cells are functioning normally, the female partner can enter the IVF process and the male partner can have a child through assisted reproduction through testicular sperm retrieval. If the biopsy does not reveal sperm, repeat puncture is also generally not recommended. Although the spermatogenesis of the testes is uneven and puncture does not cause much damage, the chances of success are not significantly improved. If the patient is willing to do it again, another puncture can be performed a month after the first one to check. Which azoospermia patients need surgical treatment If it is clearly diagnosed as obstructive azoospermia, you can choose epididymo-vas deferens anastomosis to release the obstruction. Under the microscope, the doctor will manipulate and anastomose the epididymal tube with the vas deferens, and there is a certain chance of achieving natural pregnancy. So which patients are suitable for surgical treatment? 1.Patients who have had sperm detected in their past semen tests, or have made their wives pregnant, but no sperm is found in the test now, which may be caused by obstruction; 2.Outpatient palpation examination of the testicles is normal in size, without damage, the epididymis is relatively full, and the vas deferens can be touched; 3.To do a test of sex hormones (e.g., LH, FSH), and the value of the test is in the normal range; 4.To do a seminal plasma biochemistry examination By analyzing the test results, the doctor can also help determine the location of the obstruction. Of course, since sperm can be retrieved by testicular puncture, patients with obstructive azoospermia can also get pregnant directly through second-generation IVF, in addition to surgery; during the procedure, the doctor can also remove sperm from the epididymis at the same time for freezing, which can be used for IVF if natural pregnancy fails. Trying to get pregnant one month after vaso-epididympanic anastomosis For patients with obstructive azoospermia, the use of an epididymo-vaso-epididympanic anastomosis may allow sperm to reappear in the semen. Patients need to stay in the hospital for about 1 week after the operation. During the hospitalization, they have to wear a urinary catheter for a few days, which allows them to reduce the activities of getting out of the bed and promotes the wound healing; if the patients can not tolerate the urinary catheter, such as urgency of urination and pain of urination, etc., the catheter can also be taken off on the second day of operation, and the patients will be discharged from the hospital usually after 3-4 days. Generally speaking, there will not be much discomfort after the operation.