As the old saying goes, “Unfiliality is the greatest.” Although the time has entered the 21st century, there are still many people who cling to this traditional concept of life guidelines. But imagine a family without children, it is a kind of tasteless and dark life. Producing offspring is not only a need for an integral part of the family structure, but also a reflection of male self-esteem. When diagnosed with “azoospermia”, men often feel that they are going to be “extinct” and feel that it is the end of the world for them and that they are an incomplete man. So, is there really no hope for azoospermia patients? In the case of azoospermia, there are two types of patients, one is obstructive and the other is non-obstructive. As the name implies, obstructive means that there is sperm in the testicles but it cannot come out; non-obstructive means that there is no sperm in the testicles or too little sperm to see in the semen. For obstructive azoospermia, you can follow common sense and find the site of obstruction first, such as through spermography and transrectal ultrasonography. The specific location can be found by performing vasectomy, epididymal vasectomy, etc. If the ejaculatory duct is inaccessible, ejaculation ductotomy can be tried. Because the male sperm duct has thick and thin, the thinnest place is thinner than a hair, many places are very difficult to anastomosis, and the rate of recanalization is not high when operated under the microscope. Besides, male sperm channel imaging is different from female tubal imaging, which is basically non-invasive, but male sperm channel imaging is invasive. Therefore, in my opinion, anastomosis is generally not recommended if the site of sperm duct obstruction is not clear in men (e.g. after vasectomy). We recommend that the male partner undergo a simple sperm retrieval procedure, such as percutaneous epididymal sperm aspiration or percutaneous testicular sperm aspiration, to retrieve the sperm “upstream” of the obstruction and freeze it for preservation. The frozen sperm can be thawed during the female partner’s IVF egg retrieval or the sperm can be retrieved again for intra-plasmic injection of single sperm oocytes to unite the sperm and egg to form an embryo for transfer. For non-obstructive azoospermia, some patients can still find some sperm through centrifugation or repeated examinations, and IVF treatment can still be performed if multiple freezings are performed. Foreign studies have found that for non-obstructive azoospermia, if a testicular biopsy is performed, some focal spermatogenic sites can still be found in the testes of more than half of the patients, and if sperm are retrieved, IVF treatment can still be performed. For those patients who really do not have sperm, patients can be advised to go to a hospital with a sperm bank (there are currently 11 operating sperm banks in China) for assisted conception treatment with donor sperm, or they can consider adoption. Although there are many ways to help azoospermic men fulfill their wish to become fathers. However, there are still many patients who are very interested in assisted reproduction technology, but are concerned about the safety of the technology itself, such as whether the offspring will be normal, deformed, or mentally retarded. According to the available domestic and international information and the practice of our fertility center over the years, assisted reproduction technology is generally safe based on the control of indications in accordance with the strict requirements of the Ministry of Health. However, it should be noted that for men with azoospermia, the offspring may inherit the defect that the father cannot give birth normally. Therefore, we generally recommend men with azoospermia, especially non-obstructive azoospermia, to undergo genetic examination, and the common items include karyotype analysis of chromosomes and examination of Y chromosome microdeletion. At the same time, we should be optimistic that with the rapid development of modern science and technology, perhaps in a few decades, many genetic diseases can be solved by gene level treatment, and the technology of assisted reproduction will become more and more perfect.