Non obstructive azoospermia as the only indicator of focal segmental glomerulosclerosis and chronic kidney failure: A case report

Azoospermia, the absence of sperm in the ejaculate, affects 1 % of men, with non-obstructive azoospermia (NOA) comprising 60 % of cases. We report a 29-year-old male with NOA and primary infertility, initially asymptomatic with history of chronic diseases and normal evaluations. Routine blood tests revealed elevated creatinine, leading to a diagnosis of end-stage renal disease (ESRD) due to focal segmental glomerulosclerosis. After hemodialysis and kidney transplantation, semen analysis showed cryptozoospermia, suggesting partial spermatogenesis recovery. This case highlights NOA as a potential silent indicator of systemic disease, emphasizing the importance of thorough evaluation and a multidisciplinary approach in idiopathic cases.