Curative treatment options for men with non-obstructive azoospermia

Background: Men with NOA have confined options for reproduction. Testicular sperm extraction followed by Intracytoplasmic Sperm Injection (ICSI) is feasible in these patients. But there are high costs and major problems for a female partner. If mature sperm cannot be recovered from the testes, Patients almost all lose hope in having a biological child. Therefore, the need for alternative therapies for the production of adult spermatozoa is necessary in patients with azoospermia. Many techniques are in the tentative stage to prepare this patient population alternatives for conceiving.Objective: The purpose of this study is to introduce new techniques that can be used in the future for the treatment of azoospermia men.Materials and Methods: This review considers three of the tentative techniques for returning fertility in men with NOA: spermatogonial stem cell (SSC) transplantation, in vitro spermatogenesis using adult or embryonic pluripotent stem cells, and gene therapy.Results: SSC transplantation testicular tissue grafting retains the natural stem cell niche, Cryopreservation protocols, SSC injection is the other method (This process should theoretically permit for conception without the necessity of assisted reproductive techniques, that is a great benefit). Several problems have tortured the transformation of this notion into an actual clinical therapy for patients: recognizing the SSC population in the testis, culturing the SSCs, storing of the SSCs, and reintroducing the cells safely into a recipient. There are two stem cell sources (in addition to SSCs) that might be applied in producing germ cells: human embryonic stem cells and adult pluripotent stem cells. Until the other protocol is created, adult pluripotent stem cells are not an authority as a therapy for male infertility due to their tumorigenic risks. Gene therapy needs a perfect conception of the specific genetic defect underlying the pathologic method. Unfortunately, such wisdom is lacking in the most of the cases of NOA.Conclusion: Ethical and technical restrictions create a significant obstacle to performing the suitable studies in humans and reliable reproducible protocols are essential.

کلیدواژه ها:

Non-obstructive azoospermia ، Spermatogonial stem cell ، Gene therapy