If the diagnosis of obstructive azoospermia is clear, you can choose epididymal-vasovaginal anastomosis surgery to release the obstruction. Under the microscope, the doctor will operate to anastomose the epididymal duct with the vas deferens, and there is a certain chance to achieve natural pregnancy. So which patients are suitable for surgical treatment? 1. The patient’s past semen examination has detected sperm, or once made his wife pregnant, but now the examination does not find sperm, which may be caused by obstructive reasons; 2. The testicle size is normal and not damaged by outpatient palpation examination, the epididymis is fuller and the vas deferens can be felt; 3. Do sex hormone examination (such as LH, FSH), the examination value is in the normal range; 4. Do seminal plasma biochemical examination By analyzing the test results, the doctor can also help determine the location of the obstruction. If it is ejaculatory duct obstruction, it is not suitable for vasovaginal epididymal anastomosis surgery, but should be done for spermoscopic exploratory surgery, if it is judged to be epididymal obstruction, it can be done. Of course, since sperm can be retrieved by testicular puncture, patients with obstructive azoospermia can also get pregnant directly through second-generation IVF in addition to surgery; during the surgery, the doctor can also remove sperm from the epididymis at the same time for freezing, which can be used for IVF if natural pregnancy fails.