Tharakan Tharu, Luo Rong, Jayasena Channa N, Minhas Suks
Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom.
Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, United Kingdom.
Fac Rev. 2021 Jan 26;10:7. doi: 10.12703/r/10-7. eCollection 2021.
Infertility affects 1 in 6 couples, and male factor infertility has been implicated as a cause in 50% of cases. Azoospermia is defined as the absence of spermatozoa in the ejaculate and is considered the most extreme form of male factor infertility. Historically, these men were considered sterile but, with the advent of testicular sperm extraction and assisted reproductive technologies, men with azoospermia are able to biologically father their own children. Non-obstructive azoospermia (NOA) occurs when there is an impairment to spermatogenesis. This review describes the contemporary management of NOA and discusses the role of hormone stimulation therapy, surgical and embryological factors, and novel technologies such as proteomics, genomics, and artificial intelligence systems in the diagnosis and treatment of men with NOA. Moreover, we highlight that men with NOA represent a vulnerable population with an increased risk of developing cancer and cardiovascular comorbodities.
不孕影响着六分之一的夫妻，其中男性因素导致的不孕在50%的病例中被认为是一个原因。无精子症被定义为射精中没有精子，被认为是男性因素不孕的最极端形式。从历史上看，这些男性被认为是不育的，但随着睾丸精子提取和辅助生殖技术的出现，患有无精子症的男性能够亲生自己的孩子。非梗阻性无精子症（NOA）发生在精子发生受损时。本综述描述了NOA的当代管理，并讨论了激素刺激疗法、手术和胚胎学因素，以及蛋白质组学、基因组学和人工智能系统等新技术在NOA男性诊断和治疗中的作用。此外，我们强调，患有NOA的男性是一个脆弱群体，患癌症和心血管合并症的风险增加。
