Azoospermia is a common pathological condition in male infertility, accounting for about 10% of patients with male factor infertility. Azoospermia in general has no negative impact on physical health that is cause for undue concern. However, the impact on fertility is significant, with patients having little possibility of having children through natural pregnancy, and some of them having to resort to assisted reproductive techniques using donor sperm (i.e., healthy sperm donated by others) or adoption to obtain children. The causes of azoospermia are broadly divided into 2 major categories, one is testicular spermatogenesis disorder, i.e. no sperm development and production in the testes due to congenital or acquired reasons; the other is obstructive azoospermia, i.e. normal testicular spermatogenesis, but the sperm produced cannot be excreted with semen due to obstruction of the vas deferens such as epididymis, vas deferens and ejaculatory ducts. The classification helps to choose the method of treatment. Generally, prostatitis, varicocele, non-gonococcal urethritis, and bad lifestyle habits do not cause azoospermia (some hospitals or doctors attribute azoospermia to these diseases, which is misleading). The diagnosis of azoospermia should be made by a physician based on the results of semen analysis, which should generally be made after at least 2-3 standardized semen examinations and no sperm detected after centrifugation. Some specific conditions should also be excluded. Regarding the examination of azoospermia, it is actually still relatively simple, mainly semen examination (must be checked by centrifugation); etiological examination including necessary physical examination (reproductive organs), sex hormones, chromosomes, Y chromosome AZF gene microdeletion detection; if obstructive is highly suspected and surgical recanalization is possible, only then spermography or transrectal scrotal ultrasonography is done according to the situation. The purpose of a testicular biopsy or puncture is to determine the presence or absence of sperm in the testes for the option of in vitro fertilization (commonly known as IVF) or, if possible, sperm ductal reversal surgery. Many tests and testicular biopsies are not necessary if assisted conception or surgery is not planned. This is because these tests are mostly expensive and in most cases are of little relevance for treatment. Treatment of azoospermia is very difficult. However, if obstructive azoospermia is diagnosed after the necessary tests, sperm can be obtained through epididymal or testicular puncture and used for “second-generation IVF”, i.e. single sperm intracytoplasmic injection, in order to obtain their own offspring. In the case of non-obstructive azoospermia (except in some cases where there may still be a certain amount of sperm in the testes), the only options are assisted conception or adoption using assisted sperm reproduction techniques. The latter, at least so far, has no treatment, whether Chinese or Western medicine, domestic or imported drugs, drug treatment of azoospermia is basically not much success, and there is no so-called “conditioning” method can make azoospermia cured. So I hope that patients with non-obstructive azoospermia do not have to listen to some false propaganda or take a chance, wasting money and time and energy (at least we have not seen a miracle yet). The sperm extracted from the testes or epididymis can only be used for single sperm intracytoplasmic injection technique due to its limitation in number and function, but not for normal (so-called first generation) in vitro fertilization, let alone for artificial insemination with husband sperm.