In our male doctors’ clinics, we often encounter patients with azoospermia who are very anxious and depressed and often ask, “What should I do if I don’t have sperm? Is it possible to get offspring of their own blood? What is the cause? Can we test for it? Can it be treated with medication? Do I need surgery? What are the chances of finding sperm? Are the offspring healthy? What are the risks and dangers? ………. In the face of so many questions from patients, it is necessary for us to explain in detail the causes, classification, diagnosis and treatment of azoospermia. The world’s first in vitro fertilization (IVF) was born in 1978, and Robert Edwards, the “father of IVF”, was awarded the 2010 International Congress of the American Academy of Dentistry. Robert Edwards was awarded the Nobel Prize in 2010 for this work. Prior to 1999, doctors around the world were at their wits’ end when it came to this type of patient, and the only option was sperm donation. In 1999, Professor Schlegel of Cornell Medical Center reported on microscopic testicular sperm extraction and found that, through microscopic magnification, there were still localized foci of sperm production in the testes of these patients, i.e. oases in the desert, and that these “oases” contained a large amount of sperm, enough for the woman to have her own child through IVF. However, microscopic testicular sperm retrieval is still in the developmental stage in China, and only a few large hospitals in a few provinces are able to perform it. Therefore, in China, doctors in most hospitals would advise such patients to choose only donor sperm. 1. What does azoospermia mean? Azoospermia means that no sperm is found in the ejaculated semen after centrifugal sedimentation and microscopic examination for 3 consecutive times. 2.How is azoospermia classified and how does it occur? Patients with azoospermia account for about 1% of the population of reproductive age and about 10% to 15% of infertility, including obstructive azoospermia and non-obstructive azoospermia, with patients with non-obstructive azoospermia accounting for about 60% of azoospermia. 3.What are the causes of azoospermia? (1) Obstructive azoospermia: the testes have spermatogenic function due to blockage of the vas deferens and congenital vas deficiency, etc. (2) Non-obstructive azoospermia: It can be divided into 3 categories: congenital (cryptorchidism, Creutzfeldt-Jakob syndrome and Y chromosome microdeletion, etc.), acquired (trauma, testicular torsion, varicocele, renal failure, inflammation, drugs, high temperature work, radiation and chemical injury, etc.) and idiopathic (unknown cause). 4. Can azoospermia be treated medically? At present, except for azoospermia caused by hypogonadotropic hypogonadism, which can theoretically produce sperm through long-term hormone replacement therapy, the rest of azoospermia is difficult to treat through medication. 5.The main treatment modalities of azoospermia? (1) Obstructive azoospermia (a) recanalization surgery (vas deferens-vas deferens anastomosis, vas deferens-epididididymal anastomosis, transurethral ejaculation electrosurgery); (b) ICSI treatment by testicular puncture or biopsy for sperm extraction. (2) Non-obstructive azoospermia (a) Donor sperm treatment (b) Testicular microsperm retrieval + second-generation IVF treatment.