The original testicular biopsy or puncture diagnosed as only supportive cell syndrome or no spermatogenic cells, through the microscopic sperm extraction will still get sperm?1, in fact, the male testis spermatogenic tubules have hundreds of spermatogenic tubules, each spermatogenesis pipe is about 30-70cm long, in recent years, research has found that many patients with azoospermia testis there is focal spermatogenesis phenomenon, that is, non-obstructive azoospermia! Only a few or a few dozen of the hundreds or thousands of spermatogenic tubules in the patient’s testis produce sperm. It is like a tree with hundreds of branches, only a very small number of branches have fruits, and most of the other branches only have leaves but no fruits.2 When testicular biopsy or testicular puncture is taken in the past, it is not known in which branches the fruits are located, and only a few branches (i.e., spermatogonial tubules) are randomly pulled out, so most of the results are that the fruits (i.e., the diagnosis is that spermatogonia have not been seen) are not found, and therefore the diagnosis is made as With the advancement of medical technology, these patients can now have their spermatogenesis tubes, which are thinner than hair strands, enlarged 20-30 times through more advanced surgical microscopes, so that branches with fruits (i.e., thick and full spermatogenesis tubules with spermatozoa) and branches without fruits (i.e., slender and non-sperm-producing spermatogenesis tubules) can be clearly differentiated, and can be found with purpose and precision, just as in searching for an oasis in the desert. The spermatogonia, which produce a small amount of mature sperm, can be precisely located with a purpose, and the sperm can then be used to produce their own offspring through the advanced technology of one sperm and one egg, i.e., the second generation of in vitro fertilization (IVF). Therefore, the absence of spermatogenic cells does not mean that the death penalty for infertility has been imposed.4. For example, patients with non-obstructive azoospermia such as 47,XXY (Kirschner’s Syndrome), small testes, microdeletion of the Y-chromosome, previous testicular biopsies with diagnosis of supportive cell-only syndrome, testicular spermatogonial maturation blockage, testicular spermatogenic hypoplasia, and testicular atrophy caused by secondary epididymitis of testicular inflammation, etc., can have a chance to procreate through microspermic sperm retrieval techniques. Compared with the traditional testicular biopsy to obtain sperm, micro sperm extraction has the advantages of less trauma, quicker recovery and higher success rate of sperm, most of the operation time is within 2 hours, and the cost is about 10,000 dollars. The current rate of sperm retrieval for surgical microsperm extraction is around 40-50%.