Microsurgical vasoepididymostomy is epididymis tube and vas for anastomosis under surgical microscopy to treat obstructive azoospermia. [Photo provided to chinadaily.com.cn]

Therefore, microsurgical varicocelectomy is considered the gold standard for varicocelectomy in view of its highest pregnancy rate and lowest post-operative recurrence. It also lowers the risk of complicated side effects compared to other techniques.

The prevalence of azoospermia is less than one percent among all males but much higher in infertile men, with a number of approximately 10 to 15 Percent. The causes are complicated, but approximately 40 percent of cases result from obstruction in the ductal system.

Epididymal obstruction is the most common cause of obstructive azoospermia. Previously, these patients were advised to follow intracytoplasmic sperm injection (ICSI) for reproduction regardless of obstructive causes.

Microsurgical reconstruction in patients with obstructive azoospermia also achieves high patency and pregnancy rates. Patency rates from 70 to 90 percent and pregnancy rates from 33.3 to 40 percent have been reported.