Male infertility

Reproductive technology

Obstructive azoospermia

Biology

Testicular sperm extraction

Azoospermia

Lactation

Environmental health

Geology

Current (fluid)

Oceanography

Genetics

Spermatogenesis

Assisted reproductive technology

Infertility

Population

Gynecology

Andrology

Medicine

Pregnancy

Faculty Reviews

Infertility affects 1 in 6 couples, and male factor infertility has been implicated as a cause in 50% of cases. Azoospermia is defined as the absence of spermatozoa in the ejaculate and is considered the most extreme form of male factor infertility. Historically, these men were considered sterile but, with the advent of testicular sperm extraction and assisted reproductive technologies, men with azoospermia are able to biologically father their own children. Non-obstructive azoospermia (NOA) occurs when there is an impairment to spermatogenesis. This review describes the contemporary management of NOA and discusses the role of hormone stimulation therapy, surgical and embryological factors, and novel technologies such as proteomics, genomics, and artificial intelligence systems in the diagnosis and treatment of men with NOA. Moreover, we highlight that men with NOA represent a vulnerable population with an increased risk of developing cancer and cardiovascular comorbodities.

Non-obstructive azoospermia: current and future perspectives