A wide range of etiologies can lead to nonobstructive azoospermia (Table 1). Because some of the pathological conditions that lead to nonobstructive azoospermia can be acquired or progress later in life, a history of fecundity (secondary infertility) in a man with azoospermia does not rule out nonobstructive causes.
Physical findings suggestive of nonobstructive azoospermia are summarized in Table 2. However, clinicians should be aware that many of the physical signs of nonobstructive azoospermia may be subtle. In fact, men with nonobstructive azoospermia may have a normal physical examination. Thus, prudent investigations are required to aid in making a correct diagnosis. buy asthma inhalers
Endocrinological causes of nonobstructive azoospermia
Interpretation of hormonal levels for infertile patients should be cautious. The ‘normal’ range of values from various laboratories for hormonal profiles are generally derived from a population of subjects who are not known to have any pathological conditions that can affect the particular parameters (as opposed to being from a fertile population, as is done for semen analysis). However, most men with subfertility or infertility are asymptomatic and generally are not aware of their conditions. Hence, in subfertile and infertile men, the finding of hormonal parameters falling within the wide ‘normal’ range does not rule out the possibility of subtle endocrinopathies contributing to their subfertility or infertility.