Fulltext

Global Practice Patterns in the Evaluation of Non-Obstructive Azoospermia: Results of a World-Wide Survey and Expert Recommendations

Shah R 1 , Rambhatla A 2 , Atmoko W 2 , Martinez M 2 , Ziouziou I 2 , Kothari P 2 Show all authors , Tadros N 2 , Phuoc NHV 2 , Kavoussi P 2 , Harraz A 2 , Salvio G 2 , Gul M 2 , Hamoda T 2 , Toprak T 2 , Birowo P 2 , Ko E 2 , Arafa M 2 , Ghayda RA 2 , Karthikeyan VS 2 , Saleh R 2 , Russo GI 2 , Pinggera GM 2 , Chung E 2 , Savira M 2 , Colpi GM 2 , Zohdy W 2 , Pescatori E 2 , Park HJ 2 , Fukuhara S 2 , Tsujimura A 2 , Rojas-Cruz C 2 , Marino A 2 , Mak SK 2 , Amar E 2 , Ibrahim W 2 , Sindhwani P 2 , Alhathal N 2 , Busetto GM 2 , Al Hashimi M 2 , El-Sakka A 2 , Ramazan A 2 , Dimitriadis F 2 , Timpano M 2 , Jezek D 2 , Altay B 2 , Zylbersztejn DS 2 , Wong MY 2 , Moon DG 2 , Wyns C 2 , Gamidov S 2 , Akhavizadegan H 2 , Franceschelli A 2 , Aydos K 2 , Quang VN 2 , Ashour S 2 , Al Dayel A 2 , Al-Marhoon MS 2 , Micic S 2 , Binsaleh S 2 , Hussein A 2 , Elbardisi H 2 , Mostafa T 2 , Taha E 2 , Ramsay J 2 , Zachariou A 2 , Abdelrahman IFS 2 , Rajmil O 2 , Kalkanli A 2 , Molina JMC 2 , Bocu K 2 , Duarsa GWK 2 , Ceker G 2 , Serefoglu EC 2 , Bahar F 2 , Gherabi N 2 , Kuroda S 2 , Bouzouita A 2 , Gudeloglu A 2 , Ceyhan E 2 , Hasan MSM 2 , Musa MU 2 , Motawi A 2 , Chak-Lam C 2 , Taniguchi H 2 , Ho CCK 2 , Vazquez JFS 2 , Mutambirwa S 2 , Gungor ND 2 , Bendayan M 2 , Giulioni C 2 , Baser A 2 , Falcone M 2 , Boeri L 2 , Blecher G 2 , Kheradmand A 2 , Sethupathy T 2 , Adriansjah R 2 , Narimani N 2 , Konstantinidis C 2 , Nguyen TT 2 , Japari A 2 , Dolati P 2 , Singh K 2 , Ozer C 2 , Sarikaya S 2 , Sheibak N 2 , Bosco NJ 2 , Özkent MS 2 , Le ST 2 , Sokolakis I 2 , Katz D 2 , Smith R 2 , Truong MN 2 , Le TV 2 , Huang Z 2 , Deger MD 2 , Arslan U 2 , Calik G 2 , Franco G 2 , Rashed A 2 , Kahraman O 2 , Andreadakis S 2 , Putra R 2 , Balercia G 2 , Khalafalla K 2 , Cannarella R 2 , Tuân AÐ 2 , El Meliegy A 2 , Zilaitiene B 2 , Ramirez MLZ 2 , Giacone F 2 , Calogero AE 2 , Makarounis K 2 , Jindal S 2 , Hoai BN 2 , Banthia R 2 , Peña MR 2 , Moorthy D 2 , Adamyan A 2 , Kulaksiz D 2 , Kandil H 2 , Sofikitis N 2 , Salzano C 2 , Jungwirth A 2 , Banka SR 2 , Mierzwa TC 2 , Turunç T 2 , Jain D 2 , Avoyan A 2 , Salacone P 2 , Kadıoğlu A 2 , Gupta C 2 , Lin H 2 , Shamohammadi I 2 , Mogharabian N 2 , Barrett T 2 , Danacıoğlu YO 2 , Crafa A 2 , Daoud S 2 , Malhotra V 2 , Almardawi A 2 , Selim OM 2 , Moussa M 2 , Haghdani S 2 , Duran MB 2 , Kunz Y 2 , Preto M 2 , Eugeni E 2 , Nguyen T 2 , Elshahid AR 2 , Suyono SS 2 , Parikesit D 2 , Nada E 2 , Orozco EG 2 , Boitrelle F 2 , Trang NTM 2 , Jamali M 2 , Nair R 2 , Ruzaev M 2 , Gadda F 2 , Thomas C 2 , Ferreira RH 2 , Gul U 2 , Maruccia S 2 , Kanbur A 2 , Kinzikeeva E 2 , Abumelha S 2 , Quang N 2 , Kosgi R 2 , Gokalp F 2 , Soebadi MA 2 , Paul GM 2 , Sajadi H 2 , Gupte D 2 , Ambar RF 2 , Sogutdelen E 2 , Singla K 2 , Basurkano A 2 , Kim SHK 2 , Gilani MAS 2 , Nagao K 2 , Brodjonegoro SR 2 , Rezano A 2 , Elkhouly M 2 , Mazzilli R 2 , Farsi HMA 2 , Ba HN 2 , Alali H 2 , Kafetzis D 2 , Long TQT 2 , Alsaid S 2 , Cuong HBN 2 , Oleksandr K 2 , Mustafa A 2 , Acosta H 2 , Pai H 2 , Şahin B 2 , Arianto E 2 , Teo C 2 , Jayaprakash SP 2 , Rachman RI 2 , Yenice MG 2 , Sefrioui O 2 , Paghdar S 2 , Priyadarshi S 2 , Tanic M 2 , Alfatlawy NK 2 , Rizaldi F 2 , Vishwakarma RB 1 , Kanakis G 2 , Cherian DT 2 , Lee J 2 , Galstyan R 2 , Keskin H 2 , Wurzacher J 2 , Seno DH 2 , Noegroho BS 2 , Margiana R 2 , Javed Q 2 , Castiglioni F 2 , Tanwar R 2 , Puigvert A 2 , Kaya C 2 , Purnomo M 2 , Yazbeck C 2 , Amir A 2 , Borges E 2 , Bellavia M 2 , Deswanto IA 2 , V VK 2 , Liguori G 2 , Minh DH 2 , Siddiqi K 2 , Colombo F 2 , Zini A 2 , Patel N 2 , Çayan S 2 , Al-Kawaz U 2 , Ragab M 2 , Hebrard GH 2 , Hoffmann I 2 , Efesoy O 2 , Saylam B 2 , Agarwal A 2

Affiliations 

  • 1 Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
  • 2 Global Andrology Forum, Moreland Hills, OH, USA
World J Mens Health, 2024 Apr 03.
PMID: 38606865 DOI: 10.5534/wjmh.230333

Abstract

PURPOSE: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations.

MATERIALS AND METHODS: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations.

RESULTS: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate.

CONCLUSIONS: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Similar publications