Global Practice Patterns and Variations in the Medical and Surgical Management of Non-Obstructive Azoospermia: Results of a World-Wide Survey, Guidelines and Expert Recommendations

• Published in: The world journal of men's health 2025, 43(1), , pp.92-122
• Main Authors: Rambhatla, Amarnath, Shah, Rupin, Ziouziou, Imad, Kothari, Priyank, Salvio, Gianmaria, Gul, Murat, Hamoda, Taha, Kavoussi, Parviz, Atmoko, Widi, Toprak, Tuncay, Birowo, Ponco, Ko, Edmund, Arafa, Mohamed, Ghayda, Ramy Abou, Karthikeyan, Vilvapathy Senguttuvan, Russo, Giorgio Ivan, Pinggera, Germar-Michael, Chung, Eric, Harraz, Ahmed M, Martinez, Marlon, Phuoc, Nguyen Ho Vinh, Tadros, Nicholas, Saleh, Ramadan, Savira, Missy, Colpi, Giovanni M, Zohdy, Wael, Pescatori, Edoardo, Park, Hyun Jun, Fukuhara, Shinichiro, Tsujimura, Akira, Rojas-Cruz, Cesar, Marino, Angelo, Mak, Siu King, Amar, Edouard, Ibrahim, Wael, Sindhwani, Puneet, Alhathal, Naif, Busetto, Gian Maria, Hashimi, Manaf Al, El-Sakka, Ahmed, Ramazan, Asci, Dimitriadis, Fotios, Timpano, Massimiliano, Jezek, Davor, Altay, Baris, Zylbersztejn, Daniel Suslik, Wong, Michael Yc, Moon, Du Geon, Wyns, Christine, Gamidov, Safar, Akhavizadegan, Hamed, Franceschelli, Alessandro, Aydos, Kaan, Quang, Nguyen, Ashour, Shedeed, Dayel, Adel Al, Al-Marhoon, Mohammed S, Micic, Sava, Binsaleh, Saleh, Hussein, Alayman, Elbardisi, Haitham, Mostafa, Taymour, Ramsay, Jonathan, Zachariou, Athanasios, Abdelrahman, Islam Fathy Soliman, Rajmil, Osvaldo, Kalkanli, Arif, Molina, Juan Manuel Corral, Bocu, Kadir, Duarsa, Gede Wirya Kusuma, Çeker, Gökhan, Serefoglu, Ege Can, Bahar, Fahmi, Gherabi, Nazim, Kuroda, Shinnosuke, Bouzouita, Abderrazak, Gudeloglu, Ahmet, Ceyhan, Erman, Hasan, Mohamed Saeed Mohamed, Musa, Muhammad Ujudud, Motawi, Ahmad, Cho, Chak-Lam, Taniguchi, Hisanori, Ho, Christopher Chee Kong, Vazquez, Jesus Fernando Solorzano, Mutambirwa, Shingai, Gungor, Nur Dokuzeylul, Bendayan, Marion, Giulioni, Carlo, Baser, Aykut, Falcone, Marco, Boeri, Luca, Blecher, Gideon, Kheradmand, Alireza, Sethupathy, Tamilselvi, Adriansjah, Ricky, Narimani, Nima, Konstantinidis, Charalampos, Nguyen, Tuan Thanh, Japari, Andrian
• Format: Article
• Language: English
• Subjects: Life Sciences; Reproductive Biology; 비뇨기과학
• ISSN: 2287-4208; 2287-4690
• DOI: 10.5534/WJMH.230339

Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA. A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process. Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in