Abstract: Objective To investigate the L-carnitine combined with transurethral seminal endoscopic dilatation of the ejaculatory duct effect analysis of obstructive azoospermia and prognosis.Methods 40 cases of patients with obstructive azoospermia were studied in our hospital.According to the simple random method were divided into control group and observation group，20 cases in each group.Patients underwent transurethral seminal endoscopic dilatation of the ejaculatory duct after operation，the control group was given oral vitamin E，observation group received oral l-carnitine.The therapeutic effect，active sperm rate，forward motile sperm rate，TNF- alpha，ROS level，and pregnancy status of the spouses of the two groups were compared before and after treatment.Results The effective rate of the control group was 60%，and the effective rate of the observation group was 80%.The treatment effect of the observation group was significantly better than that of the control group（P<0.05）.After treatment，two groups of patients with active sperm rate，forward movement sperm rate were higher than before treatment（P<0.05）； the observation group after treatment of active sperm rate，forward movement sperm rate was significantly better than the control group（P<0.05）.The two groups of patients with follow-up，patients in the control group after treatment，12 cases（12/20，60%） detection of sperm after treatment in the observation group were 18 cases（18/20，90%） detection of sperm； observation group of spouses of patients with clinical pregnancy and live births were higher than the control group（P<0.05）.Conclusion Therapeutic effect of L-carnitine combined with transurethral seminal endoscopic dilatation of ejaculatory duct obstructive azoospermia significantly，can effectively improve the patients with azoospermia，and improve the outcome of pregnancy after treatment.

Key words: Lcarnitine；urethral seminal vesicle , mirror；dilation of ejaculatory duct；obstructive azoospermia