An unfulfilled child wish is a relatively frequent problem. That puts a burden to both partners and the relationship. With six patient cases we demonstrate that an adequate diagnostic work-up should precede goal directed treatment in azoospermatic patients. Treatment showed good results in each of these cases. Although surgically retrieved sperm for in vitro fertilization is allowed in the Netherlands, the accessibility of the Dutch subfertile man to this kind of care is not optimal and care in foreign countries is still sought.