Abstract
The diagnosis of azoospermia is a devasting one for men – and it represents the obliteration of so many unspoken hopes and expectations. Most causes of azoospermia are not amenable to treatment but those due to hypogonadotropic hypogonadism can respond to gonadotropin therapy. This can be a lengthy and expensive treatment, but it delivers an opportunity to men to restore, albeit temporarily, their production of sperm. Encouragingly, treatment is associated with good success rates, even outside of specialist clinics. In this commentary, we present an understanding of the underlying pathophysiology in hypogonadotropic hypogonadism, together with a simple outline from leading clinics on the treatments used to induce spermatogenesis. We review options to consider before embarking on fertility-altering treatment in medicine and in surgery.
Keywords
Gonadotrophins, Hypogonadotropic hypogonadism, Sperm count, Testicular volume (TV), Spermatogenesis, Children, Subfertility