Abstract
Infertility affects 1 in 6 couples and male factor infertility is the cause in 50% of cases. Azoospermia is defined as the absence of spermatozoa in the ejaculate and is considered the most extreme form of male factor infertility. In the past, these men were considered infertile, but with the advent of testicular sperm extraction and assisted reproductive technologies, men with azoospermia can biologically father their own children. Non-obstructive azoospermia (NOA) occurs when there is a defect in spermatogenesis. This review describes the contemporary management of NOA and discusses the role of hormone stimulation therapy, surgical and embryological factors, and new technologies such as proteomics, genomics and artificial intelligence systems in the diagnosis and treatment of men with NOA. We also emphasise that men with NOA represent a vulnerable population at high risk of developing cancer and cardiovascular comorbidities. Keywords: azoospermia, non-obstructive azoospermia, infertility, hypogonadism
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