Volume 27, Issue 3 (May 2025) 27, 433–439; 10.4103/aja202486
Future prospects for the advancement of treatment of men with NOA: focus on gene editing, artificial sperm, stem cells, and use of imaging
Akeem Babatunde Sikiru1, Manh Nguyen Truong2, Wael Zohdy3
1Department of Animal Science, Federal University of Agriculture Zuru (FUAZ), Kebbi 872101, Nigeria; 2Fertility Centre, Hanh Phuc International Hospital, Ho Chi Minh City 70000, Vietnam; 3Andrology and STIs, Cairo University, Giza 12613, Egypt.
Correspondence: Dr. AB Sikiru (akeembaba01@gmail.com)
Received: 27 January 2024; Accepted: 20 August 2024; published online: 11 October 2024
Abstract |
Nonobstructive azoospermia (NOA) affects about 60% of men with azoospermia, representing a severe form of male infertility. The current approach to manage NOA primarily involves testicular sperm retrieval methods such as conventional testicular sperm extraction (c-TESE) and microdissection testicular sperm extraction (micro-TESE). While combining testicular sperm retrieval with intracytoplasmic sperm injection (ICSI) offers hope for patients, the overall sperm retrieval rate (SRR) stands at around 50%. In cases where micro-TESE fails to retrieve sperm, limited options, like donor sperm or adoption, can be problematic in certain cultural contexts. This paper delves into prospective treatments for NOA management. Gene editing technologies, particularly clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated (Cas) protein 9 (CRISPR/Cas9), hold potential for correcting genetic mutations underlying testicular dysfunction. However, these technologies face challenges due to their complexity, potential off-target effects, ethical concerns, and affordability. This calls for research to address key challenges associated with NOA management within the clinical settings. This also necessitate ongoing research essential for developing more sensitive diagnostic tests, validating novel treatments, and customizing current treatment strategies for individual patients. This review concluded that the future of NOA management may entail a combination of these treatment options, tailored to each patient’s unique circumstances, providing a comprehensive approach to address NOA challenges.
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