Azoospermia is the most serious disease in male fertility. About 10% of male patients who go to regular hospital male department for semen examination due to infertility cannot find sperm on routine semen examination, and no sperm is found on sedimentation smear examination after further semen centrifugation, so the diagnosis of azoospermia is considered, but 3 times of semen centrifugation is needed to confirm. After the diagnosis of azoospermia, further detailed examinations such as: peripheral blood karyotype, y chromosome microdeletion, sex hormone + INHB + AMH examination, scrotal + transrectal ultrasound, and testicular puncture biopsy if necessary are required. The etiology of azoospermia is routinely divided into pre-testicular (hypothalamic-pituitary), testicular, and post-testicular (vas deferens – obstructive). Currently, azoospermia is routinely divided into two major categories according to the convenience of clinical diagnosis and treatment: non-obstructive azoospermia (NOA), and obstructive azoospermia (OA). The first choice of treatment for obstructive azoospermia (OA) is to consider the possibility of vasovaginal tract recanalization. However, not all patients are suitable for microsurgical recanalization. For example, surgical recanalization is not recommended in cases such as vas deferens, older spouse and obstructed fallopian tubes. The current overall surgical recanalization rate is between 50-75%, and the ability to conceive a spouse naturally accounts for about half of these cases. Even if the recanalization is unsuccessful, it can be referred to IVF (ICSI-ET) with a higher success rate. In non-obstructive azoospermia (NOA), after excluding obvious genetic abnormalities, about half of the patients can find sperm for IVF due to current advances in microscopic sperm retrieval techniques and updated concepts, and of those who find sperm, about half can obtain normal offspring through IVF (ICSI-ET) techniques. Of course, it is best to treat NOA with medication for more than 3 months before sperm retrieval to increase the success rate of sperm retrieval. In a small number of NOA patients, after testicular biopsy puncture with medication, the semen routine was rechecked and a large amount of live sperm could be found in the semen. Therefore, even for patients diagnosed with azoospermia, there is no need to be too sad, as sperm can be “created from nothing” through medication, microscopic recanalization, or microscopic sperm retrieval techniques, and genetic offspring can be obtained in combination with in vitro fertilization (ICSI-ET). What are the benefits?