Non-obstructive azoospermia (NOA )

 

Non-obstructive azoospermia (NOA )

 

Non-obstructive azoospermia (NOA) is diagnosed in approximately 10% of infertile men. It represents a failure of spermatogenesis within the testis

How to manage ? Can they become father? WE should understand the caused first ,Such are  due to either a A) Receptor defect :-lack of appropriate stimulation by gonadotropins or B) an intrinsic testicular impairment.

The former category of patients has hypogonadotropic hypogonadism / abnormal molecules of endogenous gonadotrophins and may benefits from specific hormonal therapy. These men show a remarkable recovery of spermatogenic function with exogenously administered gonadotropins (because such exogenous gonadotrophins has normal carbohydrate moiety )  or gonadotropin-releasing hormone.

B) NOA :- This category of patients also includes some individuals whose spermatogenic potential has been suppressed by excess androgens or steroids, and they also benefit from medical management.

C) The other, larger category of non-obstructive azoospermia consists of men with an intrinsic testicular impairment where empirical medical therapy yields little benefit. The primary role of medical management in these men is to improve the quantity and quality of sperm retrieved from their testis for in vitro fertilization(ICSI) . Gonadotropins and aromatase inhibitors show promise in achieving this end point.