title: Medical management of non-obstructive azoospermia.
abstract: Non-obstructive azoospermia is diagnosed in approximately 10% of infertile men. It represents a failure of spermatogenesis within the testis and, from a management standpoint, is due to either a lack of appropriate stimulation by gonadotropins or an intrinsic testicular impairment. The former category of patients has hypogonadotropic hypogonadism and benefits from specific hormonal therapy. These men show a remarkable recovery of spermatogenic function with exogenously administered gonadotropins or gonadotropin-releasing hormone. 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. 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. Gonadotropins and aromatase inhibitors show promise in achieving this end point.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, New Delhi, India. rajeev02@gmail.com
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
mesh_terms: D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D053713:Azoospermia / Q000145:classification / Q000188:drug therapy* / Q000209:etiology; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D007006:Hypogonadism / Q000145:classification / Q000150:complications / Q000188:drug therapy; D008297:Male; D013091:Spermatogenesis; D013739:Testosterone / Q000172:deficiency
chemical_list: D047072:Aromatase Inhibitors; D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone