In this episode, we explore the genetic landscape of Y-chromosome microdeletions, a leading cause of male infertility affecting the Azoospermia Factor (AZF) regions. We examine the distinct clinical outcomes for AZFa, AZFb, and AZFc deletions—ranging from complete spermatogenic failure to successful sperm retrieval via micro-TESE. Finally, we discuss the critical role of genetic counseling regarding vertical transmission to sons and emerging links to broader male health issues like cardiovascular disease and cancer.