Hormonal Treatment of Men with Nonobstructive Azoospermia: What Does the Evidence Suggest?

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Jan 27

PMID 33498414

Citations 15

Authors

Ettore Caroppo

Giovanni M Colpi

Affiliations

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Abstract

Hormonal stimulation of spermatogenesis prior to surgery has been tested by some authors to maximize the sperm retrieval yield in patients with nonobstructive azoospermia. Although the rationale of such an approach is theoretically sound, studies have provided conflicting results, and there are unmet questions that need to be addressed. In the present narrative review, we reviewed the current knowledge about the hormonal control of spermatogenesis, the relationship between presurgical serum hormones levels and sperm retrieval rates, and the results of studies investigating the effect of hormonal treatments prior to microdissection testicular sperm extraction. We pooled the available data about sperm retrieval rate in patients with low vs. normal testosterone levels, and found that patients with normal testosterone levels had a significantly higher chance of successful sperm retrieval compared to those with subnormal T levels (OR 1.63, 95% CI 1.08-2.45, = 0.02). These data suggest that hormonal treatment may be justified in patients with hypogonadism; on the other hand, the available evidence is insufficient to recommend hormonal therapy as standard clinical practice to improve the sperm retrieval rate in patients with nonobstructive azoospermia.

Citing Articles

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Prevalence and clinical implications of biochemical hypogonadism in patients with nonobstructive azoospermia undergoing infertility evaluation.

Achermann A, Esteves S F S Rep. 2024; 5(1):14-22.

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Clinical management, differential diagnosis, follow-up and biomarkers of infertile men with nonobstructive azoospermia.

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Frequency, morbidity and equity - the case for increased research on male fertility.

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Male Infertility: A Review of Key Papers Appearing in the Reproductive Medicine and Andrology Section of the .

Caroppo E, Colpi G J Clin Med. 2023; 12(6).

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