{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:54:26Z","timestamp":1791849266793,"version":"4.3.4"},"reference-count":95,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The differential diagnosis between obstructive and nonobstructive azoospermia is the first step in the clinical management of azoospermic patients with infertility. It includes a detailed medical history and physical examination, semen analysis, hormonal assessment, genetic tests, and imaging studies. A testicular biopsy is reserved for the cases of doubt, mainly in patients whose history, physical examination, and endocrine analysis are inconclusive. The latter should be combined with sperm extraction for possible sperm cryopreservation. We present a detailed analysis on how to make the azoospermia differential diagnosis and discuss three clinical cases where the differential diagnosis was challenging. A coordinated effort involving reproductive urologists\/andrologists, geneticists, pathologists, and embryologists will offer the best diagnostic path for men with azoospermia.<\/jats:p>","DOI":"10.3390\/jcm10143144","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T10:52:58Z","timestamp":1626432778000},"page":"3144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":95,"title":["Differential Diagnosis of Azoospermia in Men with Infertility"],"prefix":"10.3390","volume":"10","author":[{"given":"Danilo L.","family":"Andrade","sequence":"first","affiliation":[{"name":"Department of Medical Physiopathology (Postgraduate Program), State University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina C.","family":"Viana","sequence":"additional","affiliation":[{"name":"Department of Surgery (Residency Program), Division of Urology, State University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1313-9680","authenticated-orcid":false,"given":"Sandro C.","family":"Esteves","sequence":"additional","affiliation":[{"name":"ANDROFERT, Andrology & Human Reproduction Clinic, Campinas 13075-460, SP, Brazil"},{"name":"Department of Surgery, Division of Urology, State University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.6061\/clinics\/2013(Sup01)05","article-title":"The importance of semen analysis in the context of azoospermia","volume":"6","author":"Aziz","year":"2013","journal-title":"Clinics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.6061\/clinics\/2013(Sup01)03","article-title":"The epidemiology and etiology of azoospermia","volume":"68","author":"Cocuzza","year":"2013","journal-title":"Clinics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/j.1365-2605.2010.01087.x","article-title":"Clinical experience with azoospermia: Aetiology and chances for spermatozoa detection upon biopsy","volume":"34","author":"Werny","year":"2011","journal-title":"Int. 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