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.
| Original language | English |
|---|---|
| Pages (from-to) | 727-748 |
| Number of pages | 22 |
| Journal | World Journal of Men's Health |
| Volume | 42 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Oct 2024 |
Bibliographical note
Copyright 2024 Korean Society for Sexual Medicine and Andrology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.Keywords
- Azoospermia
- Diagnosis
- Guideline
- Infertility, male
- Surveys, questionnaires
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In: World Journal of Men's Health, Vol. 42, No. 4, 10.2024, p. 727-748.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Global practice patterns in the evaluation of non-obstructive azoospermia
T2 - results of a world-wide survey and expert recommendations
AU - Shah, Rupin
AU - Rambhatla, Amarnath
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AU - Al Hashimi, Manaf
AU - El-Sakka, Ahmed
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AU - Dimitriadis, Fotios
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AU - Wong, Michael Y. C.
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AU - Wyns, Christine
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AU - Akhavizadegan, Hamed
AU - Franceschelli, Alessandro
AU - Aydos, Kaan
AU - Quang, Vinh Nguyen
AU - Ashour, Shedeed
AU - Al Dayel, Adel
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AU - Micic, Sava
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AU - Musa, Muhammad Ujudud
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AU - Taniguchi, Hisanori
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AU - Vazquez, Jesus Fernando Solorzano
AU - Mutambirwa, Shingai
AU - Gungor, Nur Dokuzeylul
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AU - Falcone, Marco
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AU - Ramirez, Marlene Lizbeth Zamora
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AU - Banka, Surendra Reddy
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AU - Danacıoğlu, Yavuz Onur
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AU - Daoud, Salima
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AU - Moussa, Mohamad
AU - Haghdani, Saeid
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AU - Gilani, Mohammad Ali Sadighi
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AU - Margiana, Ria
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AU - Zini, Armand
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AU - Hebrard, Guadalupe Hernández
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N1 - Copyright 2024 Korean Society for Sexual Medicine and Andrology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2024/10
Y1 - 2024/10
N2 - 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.
AB - 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.
KW - Azoospermia
KW - Diagnosis
KW - Guideline
KW - Infertility, male
KW - Surveys, questionnaires
UR - http://www.scopus.com/inward/record.url?scp=85194961760&partnerID=8YFLogxK
U2 - 10.5534/WJMH.230333
DO - 10.5534/WJMH.230333
M3 - Article
C2 - 38606865
AN - SCOPUS:85194961760
SN - 2287-4208
VL - 42
SP - 727
EP - 748
JO - World Journal of Men's Health
JF - World Journal of Men's Health
IS - 4
ER -