VE anastomosis has been significantly improved in recent years, from end-to-end anastomosis to end-to-lateral anastomosis, from three-needle anastomosis to two-needle anastomosis, from transverse phase anastomosis to longitudinal anastomosis. 2007, the development of single-needle longitudinal anastomosis technique has solved the problem of lack of double-needle 10-0 anastomosis line in many areas, and to some extent promoted the development and popularity of male infertility microsurgery. However, only a few hospitals in a few cities in China can carry out vas deferens epididymal duct anastomosis.VE anastomosis for the treatment of OA requires a high level of surgical technique. In the case of double needle anastomosis, the suture needle is inserted into and out of the vas deferens and the operation is relatively simple, but the lack of double needles for anastomosis in China hinders the popularization of double needle VE technique. Single-needle anastomosis can solve this problem, but when suturing the mucosa of the vas deferens, the direction of needle entry is first external inward and then internal outward, which makes the operation significantly more difficult, especially the direction of needle entry during the suturing of the epididymal duct should be paid attention to during the surgical operation. In our clinical operation, we have gradually developed a new single-needle anastomosis scheme, called “reverse” single-needle vas deferens-epidididymal anastomosis, which can solve the problem of lack of double-needle sutures for anastomosis, and at the same time facilitate the operator to choose the needle site according to the operating habits and intraoperative conditions. The advantages of the three techniques complement each other, making it easy for the operator to choose different anastomoses according to the actual situation, forming a new anastomosis scheme in which double-needle anastomosis and single-needle cis- and trans-anastomosis complement each other, thus better promoting the popularity of vas deferens-epidididymal anastomosis and to a certain extent promoting the development of related technologies in the field of male reproduction. Microscopic ligation of varicocele has obvious advantages compared with previous open and laparoscopic surgical methods: intraoperative exposure of the testis allows visual observation of the external spermatic vein and the testicular collecting vein, effectively preventing recurrence of varicocele; intraoperative rubber skin sheet isolates the vas deferens vascular bundle and the internal spermatic cord vascular bundle, avoiding damage to the vas deferens and its blood supply; intraoperative Doppler ultrasound can help accurately identify and protect the testicular artery and its branches, the levator ani and its branches, and postoperative Doppler ultrasound can help accurately identify and protect the testicular artery and its branches. Intraoperative Doppler ultrasound can help accurately identify and protect the testicular artery and its branches, the levator artery and its branches, and reduce postoperative testicular atrophy, which did not occur in our study; the internal spermatic vein was ligated with titanium clips or ligature wires to save surgical time and reduce surgical trauma; intraoperative microscopic bipolar electrocoagulation was used to stop hemorrhage and reduce local injury while effectively preventing postoperative inguinal hematoma. In terms of NOA treatment, despite the continuous development of surgical sperm extraction, a large proportion of NOA patients still have difficulty in obtaining found sperm. In clinical practice, we have effectively combined the existing sperm retrieval procedures and applied the established “three-step sperm retrieval procedure” in a comprehensive manner, taking a step-by-step approach and performing a gradual in-depth exploration to minimize the trauma of the procedure, the difficulty of the operation and the economic burden on the patient while ensuring the sperm acquisition rate [5]. It has been proved that “three-step sperm extraction” is operable, has a high success rate, and is easily accepted by patients, which is a new method for NOA treatment, especially in patients with azoospermia after cryptorchidism, the sperm acquisition rate is as high as 69.7%, which may be related to the local temperature change of the testis after surgery. It is worthwhile to educate us to use the three-step sperm retrieval procedure to improve the possibility of patients to have progeny. To establish a model of male infertility microsurgery combined with ICSI to help conception, VV anastomosis, VE anastomosis, M-TESE, MESA to obtain sperm during surgery to perform sparse sperm cryopreservation and prepare ICSI to help conception, to preserve the patient’s fertility or to save the patient from the pain of reoperation and to solve the patient’s fertility problem.