Normogonadotropic azoospermia: the puzzle of hormonal treatment

The editorial proposes an original algorithm for hormonal treatment of patients with normogonadotropic azoospermia (NOAN). This condition is very common in clinical practice, and the approach of endocrinologists varies. Different therapeutic strategies are recommended based on clinical (testicular volume and body mass index) and hormonal parameters (inhibin B and 17-alpha hydroxyprogesterone levels). The algorithm suggests the role of follicle-stimulating hormone or chorionic gonadotropin, or incretin therapy, which are fully included in the potential therapeutic proposal due to the significant repercussions of metabolic syndrome and obesity on sperm quality.