IVF often comes to mind when we see male infertility, and when a patient with infertility encounters a problem, he or she will want to do IVF, but natural conception is probably our highest pursuit. After all, IVF is a kind of artificial conception, which is more costly and damaging to women, and it is an artificial and unnatural fertility. In recent years, microsurgical techniques have found a new approach for the treatment of male infertility. 1. How are microsurgical techniques implemented? For microsurgery technique, the surgeon has to perform some surgical procedures on the patient with the help of an operating microscope, which is generally able to magnify 25-40 times, in an extremely fine operating environment. Microsurgical varicocele ligation, microsurgical vasovaginal anastomosis by epididymis, and microscopic vasovaginal anastomosis, and also microscopic testicular sperm extraction can be done. In terms of the infertility population, WHO statistics show that 10%-15% of the infertility couples, 50% of the causes are related to men, and about 40% of the patients are related to varicocele. Microsurgery is also a very important step, as sperm can often be found through microscopic sperm extraction in cases where the testes cannot find sperm, making IVF a possibility for patients. Microscopic techniques are better than IVF I’ll start with spermatozoa varicose veins, we do microscopic ligation under a magnified view of 25 times, according to a study of 1500 cases in a large foreign case, the pregnancy rate in one year of treatment is 43% and two years can reach 69%. There are of course many causes of obstructive azoospermia, and the international surgical recanalization rate can reach 70%-80% from azoospermia to spermia, and the pregnancy rate can reach 30%-40%, which is comparable to IVF, but its damage is much lower than IVF. The comparison between microscopy and IVF technology, the success rate of microscopy technology can reach about 80% or more, the conception factor and the number of intercourse of the patient has a relationship, and the object of treatment is only the male; to do IVF to involve both men and women, especially women to pay a great price for artificial ovulation; cost to do microsurgery 10,000-15,000. In vitro fertilization is generally known to cost 20,000 to 30,000; the operation time is more because we are more delicate and take more time, but our treatment process is relatively simple, IVF treatment process is complex and the cycle is longer, and in terms of genetics microscopic technology is natural conception, which is the highest law of fertility, IVF is artificial random selection, the genetic risk is still very large. For non-obstructive azoospermia, such as small testes, testicular dysplasia or testicular atrophy, we often say that testicular puncture biopsy or testicular biopsy cannot find sperm, for these patients, IVF is not possible in the past, only human sperm bank co-sperm or adoption, many people regret not being able to have their own biological parentage, but microscopic sperm retrieval makes it possible for you to get your own biological parentage once again. However, microscopic sperm retrieval makes it possible for you to obtain your own biological parent once again. Microscopic sperm retrieval at a magnification of 40 times is possible for 40%-70% of people, which is many times higher than the success rate of testicular puncture biopsy. The success rate of sperm retrieval is 40.7%. Please note that this is 40% of the people who failed in testicular puncture or biopsy sperm retrieval, but we have a 100% success rate in 13 cases of thawing, 11 embryo transfers and 9 pregnancies. What is the significance of microsurgery? Finally, we say that the significance of microsurgery is that it gives patients with traditional oligozoospermic infertility an additional hope for treatment and gives us an additional effective means to obtain results. Previously some patients with obstructive azoospermia had to go through IVF to obtain conception, now we are able to make these patients conceive naturally. In addition, we can make it possible for patients to obtain their own biological parentage when no sperm could be found by testicular biopsy or puncture in the past. Microsurgery is still an emerging and rapidly developing discipline for the treatment of male infertility, and our male center at Peking University Hospital has published many influential academic articles on microsurgery internationally over the past few years, and has been recognized by IVF fertility centers that microsurgery can make natural conception possible.