Azoospermiacouldbeeithernonobstructiveazoospermia(NOA)orobstructive azoospermia (OA).Clinical assessment (testis consistency&volume),laboratory
testing(FSH),andgenetictesting (karyotype, Y chromosome microdeletion,orspecificgenetic testing for hypogonadotropic hypogonadism) are used to distinguish NOA (which includes primaryand secondarytesticular
failure)from OA.Thetreatment of NOA is still empirical. For hypogonadotropichypogonadism,
gonadotropintherapyistheonly particular indication that consistently improves semen analysisandratesofconception.
Thetypicaltreatmentconsists of gonadotropins (hCG and rFSH) combined, with GnRH therapy maintained for non-responders.
Although there is apaucity of level
I clinical data, drug therapy combining aromatase inhibitors and gonadotropins may be able to improve outcomes for men who needsurgicalsperm retrieval.This
review offersa currentoverview
ofthe causes,treatments,and
management of non-obstructive
azoospermia.