Infertility is becoming more and more common. In male infertility (that is, infertility due to male factors), the main causes are oligospermia, deformed sperm, azoospermia, and so on. However, a sperm problem does not mean that there is no chance of having a child. Assisted reproductive technology brings hope to many families, but there are several types of assisted reproductive technology, including artificial insemination and IVF, how do they differ? What kind of assisted reproductive technology should be used when the male partner is infertile? What are the current assisted reproduction techniques? What are the differences between them? The two main types of assisted reproductive technologies are artificial insemination and IVF (in vitro fertilization-embryo transfer). In the case of artificial insemination, the male partner’s semen is first taken out, washed and optimized in vitro to find the part of sperm with good vitality, and then delivered to the woman’s uterine cavity through an injection device on her ovulation day, allowing the sperm and egg to unite naturally in the woman’s body, and the whole process is painless. According to the source of sperm, there are two types of artificial insemination: “husband insemination” and “donor insemination”, which are commonly known as artificial insemination with the sperm of one’s husband and artificial insemination with the sperm of others (sperm bank). IVF includes first, second and third generation IVF. The first generation of IVF involves removing both the male partner’s sperm and the female partner’s egg, then fertilizing them in a petri dish and developing them into embryos, from which the doctor then selects good quality embryos to be transferred back to the female partner’s uterus for implantation and development; this technique only provides a platform for the sperm to combine well with the egg, and the doctor does not directly interfere with which sperm unites with the egg; it is mainly for female infertility with tubal factors. However, second generation IVF is different, it is called intracytoplasmic single sperm injection (ICSI), which is a microscopic device in which the doctor directly injects a single sperm into the oocyte plasma to fertilize it; in other words, this sperm must rely on human help to unite with the egg; it is mainly for male infertility patients with few, weak or abnormal spermatozoa. The third generation of IVF, on the other hand, is based on the second generation of IVF, where genetic diagnosis is performed and healthy embryos are picked out and transferred back into the uterus. It is not a matter of who is better than whom among the various assisted reproductive technologies, but each has its own indications. Which assisted reproduction technique is suitable for sperm problems? First of all, when there is a sperm problem, it is still important to find the cause and see if it can be treated by other means, such as improving the quality of semen by taking medication or surgery. Usually, we will observe for 3 months to 6 months; for older patients, we may observe for 3 months, while for younger patients, we still recommend observing for about 6 months to see if there is any chance to get pregnant on your own; after all, the combination of sperm and egg is also a process of superiority and inferiority in accordance with the law of nature. After treatment and observation, no pregnancy has been achieved. Then we can consider assisted reproductive technology. If the female partner has normal ovulation and no tubal blockage, and the male partner has only mild to moderate oligospermia or weak spermatozoa, but not severe abnormal spermatozoa, the assisted reproductive means of artificial insemination can be chosen. Even if the male partner does not have sperm (azoospermia), as long as the female partner is normal, artificial insemination can also be used, just to take sperm from the sperm bank for assisted reproduction. If you have done artificial insemination three times and failed, you generally have to do the first generation of IVF, of course, some people can continue to try artificial insemination a few more times. However, if there is severe oligospermia, weakness or malformation, IVF should probably be an option from the beginning. As for the second generation IVF technology, it is mainly for extreme oligospermia, weak spermia and teratospermia; severe oligo- and weak-teratospermia (sperm density <5×106/ml, viability (a+b) <10%, normal morphology <4%); sperm acrosome abnormalities; irreversible obstructive azoospermia (failed recanalization surgery, but sperm can still be found under the microscope); spermatogenic dysfunction (non- obstructive azoospermia, excluding genetic factors) and other male factor-induced infertility. The third generation IVF technology, on the other hand, is mainly used when screening for genetic diseases is needed, such as screening for geodysgenesis, chromosomal translocations, etc. What is the current success rate of assisted reproduction? What is the cost? Currently, the pregnancy rate for artificial insemination is about 10%-15%. If the male partner is infertile and chooses to do IVF, the national average is 40%-50% success rate (including first and second generation technologies), and individual fertility centers may reach 60%. Of course, the pregnancy rate does not mean the final success, because some people will have miscarriage, embryonic arrest, premature birth and other problems after pregnancy, so those who can successfully deliver and carry home (we call it the baby carrying rate) is about 40%. As for the cost, generally speaking, each IUI is about two to three thousand and one IVF is about 25,000, including the pre-testing cost. Of course, if IVF fails the first time, you only need to thaw the embryos for the second time, and the cost is about 4,000 to 5,000 each time; until the embryos are used up and still unsuccessful, if you want to continue, you have to grow the embryos again, and the cost goes back to about the same as the first time you did IVF.