Due to environmental problems and food safety factors, the quality of modern male sperm is getting worse and worse, and some patients even show azoospermia. Azoospermia accounts for about 1% of the whole population and 10%-15% of the infertility patients. Once diagnosed with azoospermia, it is like a bolt from the blue for patients and their families, but it is not the end of the world, because with the advancement of technology, more and more azoospermia patients can now have their own offspring through various means, here the editor briefly introduces how patients should proceed to the next step of treatment when told by the doctor that there is no sperm in the semen: First of all, the semen routine should be rechecked When told for the first time that there is no sperm in the semen When you are told for the first time that there is no sperm in the semen, you do not need to be confused immediately, because only three or more semen examinations in which no sperm is found in the semen can be truly diagnosed as azoospermia. There is another clinical condition called occult spermatozoa, which means that the sperm count is so low that sometimes it is not detectable, but it is possible to successfully find sperm through rechecking. Even if there is no sperm in three or more consecutive semen tests, there is no need to panic because there are two types of azoospermia: 1. obstructive azoospermia, which refers to sperm production in the testes, but the sperm transport duct is blocked or caused by congenital dysplasia. 2. non-obstructive azoospermia, which refers to various factors including congenital factors such as chromosomal abnormalities, and acquired factors such as mumps, orchitis, radiotherapy, etc. causing Sperm production in the testes is impaired. The management of obstructive azoospermia is relatively easy, as it is possible to have a child of one’s own by microsurgery to remove the obstruction or by direct sperm extraction from the testes/epididymis. The difficulty is how to find sperm for patients with non-obstructive azoospermia. For such patients, the Department of Gynecology of the Sixth Zhongshan Hospital has a series of measures: if the azoospermia is caused by some congenital factors such as hypogonadism syndrome, gonadotropin or pituitary hormone pump therapy can be used for more than six months to have a half chance of finding sperm. For some other congenital factors such as Crohn’s syndrome, or acquired factors such as mumps, orchitis, radiotherapy, etc. causing low testicular spermatogenesis, or idiopathic microspermia, we have successfully found sperm for more than 50% of these patients through microscopic sperm retrieval; and for some other idiopathic azoospermia, we can treat them repeatedly through a combination of treatment including drugs such as gonadotropins, letrozole, and Chinese medicine after dialectical diagnosis and treatment. For other idiopathic azoospermia, we can successfully find sperm for some patients through a combination of treatment including medications such as gonadotropins, letrozole, repeated centrifugal testing after Chinese medicine, combined with surgical sperm extraction. Of course, patients often have other questions, such as 1. How many months of semen test sheets do patients with azoospermia need to bring to the clinic? What other documents should I bring in addition to the semen checklist? Please bring all the test results from the outside hospital to the first visit, as this will help the doctor to make a correct diagnosis and avoid duplication of tests. 2. Do I need to abstain from sex before the visit? It is recommended to abstain from sex for about one week before the consultation. 3.Does it have to be the patient himself or herself, can someone else bring the materials for the consultation? We do not recommend that other people bring the materials to the clinic on behalf of the patient, because the physical examination by the doctor is very important, and some congenital factors such as vas deferens may make a preliminary judgment through the physical examination. 4.When do couples need to visit the clinic at the same time? The Reproductive Center of Zhongshan Sixth Hospital has always advocated that couples should be seen at the same time, because having a child is not something that can be done by one person in a couple independently. If the doctor thinks a testicular biopsy is needed after examination, he or she will help schedule the procedure as soon as possible. Generally, a normal testicular biopsy will be completed within one to two weeks, and even if microscopic sperm extraction is needed, it will be scheduled within a month.