Some experts state, “The only way for azoospermia patients to have children is to try in vitro fertilization or give up treatment.” Is this really the case? Of course the answer is no, no! The truth is: there are still many chances and hopes! Azoospermia is a common type of male infertility disease, according to epidemiological surveys, the prevalence of normal male population is close to 1-2%, that is to say, among 100 men, 1-2 people are azoospermia, of which 20% belong to obstructive azoospermia, 80% for non-obstructive azoospermia. Among obstructive azoospermia, epididymal obstruction accounts for 30-67%, which can be surgically recanalized through microscopic vasovaginal epididymal anastomosis, with a success rate of 80%; vasovaginal medical obstruction accounts for 2-6%, which can be surgically recanalized through microscopic vasovaginal anastomosis, with a success rate of 75-99%. Comprehensive data of obstructive azoospermia, microscopic anastomosis may enable the recanalization of the seminal tract in nearly 70% of patients! In non-obstructive azoospermia with combined varicocele, if microscopic sperm ligation is performed first, sperm may appear in the semen 1 year after surgery in nearly 40% of patients, 60% of these patients can conceive spontaneously and the remaining 60% can obtain sperm for ICSI or IVF by microscopic testicular sperm retrieval; if there is no combined varicocele, microscopic testicular In the absence of combined varicocele, microscopic testicular sperm extraction can help 60% of patients to obtain sperm, 40% of which can be used for ICSI or IVF. Overall, microscopic surgery can eventually help 2/3 of patients with difficult-to-treat azoospermia, so patients with azoospermia should be evaluated by a urologist familiar with microscopic surgery before treatment options are determined, rather than just “test-tube” or “give up”! It is not just “test tube” or “give up”!