Management of Secondary Hypogonadism in Men with NOA

Secondary hypogonadism can lead to nonobstructive azoospermia. Options of treatment include hCG, HMG, recombinant FSH and LH, GnRH, SERMs, and aromatase inhibitors. Surgical sperm extraction paired with ART may yield the best result but personalized medical treatment tailored to a specific patient can yield comparable results, obviating the need for invasive interventions. For couples unable to conceive naturally, even with medical management, these medical therapies may enhance success rates of surgical sperm extraction or facilitate less invasive ART interventions.