Taha Hamoda, Rupin Shah, Taymour Mostafa, Germar-Michael Pinggera, Widi Atmoko, Amarnath Rambhatla, Manaf Al Hashimi, Selahittin Çayan, Giovanni Maria Colpi, Hiva Alipour, Edmund Ko, Armand Zini, Fotios Dimitriadis, Ayman Rashed, Hyun Jun Park, Ramadan Saleh, Tuncay Toprak, Aleksei Ryzhkov, Ateş Kadıoğlu, Hussein Kandil, Arif Kalkanli, Ahmed I El-Sakka, Gokhan Calik, Marco Falcone, Haitham Elbardisi, Mohamed Arafa, Christopher Chee Kong Ho, Marlon Pedrozo Martinez, Saleh Binsaleh, Ahmad Tarek Motawi, Nazim Gherabi, Akira Tsujimura, Hisanori Taniguchi, Raghavender Kosgi, Aldo E Calogero, Taras Shatylko, Dongsuk Kim, Charalampos Thomas, Nicholas N Tadros, Sotiris Andreadakis, Muhammad Ujudud Musa, Charalampos Konstantinidis, Mirko Preto, Tan V Le, Kareim Mohamed Khalafalla, Rossella Cannarella, Kasonde Bowa, Balasingam Balagobi, Darren Jonathan Katz, Quang Nguyen, Raman Tanwar, Edson Borges Junior, Ashok Agarwal
{"title":"全球男科论坛（GAF）关于非阻塞性无精子症管理的临床指南：弥合争议与共识之间的差距。","authors":"Taha Hamoda, Rupin Shah, Taymour Mostafa, Germar-Michael Pinggera, Widi Atmoko, Amarnath Rambhatla, Manaf Al Hashimi, Selahittin Çayan, Giovanni Maria Colpi, Hiva Alipour, Edmund Ko, Armand Zini, Fotios Dimitriadis, Ayman Rashed, Hyun Jun Park, Ramadan Saleh, Tuncay Toprak, Aleksei Ryzhkov, Ateş Kadıoğlu, Hussein Kandil, Arif Kalkanli, Ahmed I El-Sakka, Gokhan Calik, Marco Falcone, Haitham Elbardisi, Mohamed Arafa, Christopher Chee Kong Ho, Marlon Pedrozo Martinez, Saleh Binsaleh, Ahmad Tarek Motawi, Nazim Gherabi, Akira Tsujimura, Hisanori Taniguchi, Raghavender Kosgi, Aldo E Calogero, Taras Shatylko, Dongsuk Kim, Charalampos Thomas, Nicholas N Tadros, Sotiris Andreadakis, Muhammad Ujudud Musa, Charalampos Konstantinidis, Mirko Preto, Tan V Le, Kareim Mohamed Khalafalla, Rossella Cannarella, Kasonde Bowa, Balasingam Balagobi, Darren Jonathan Katz, Quang Nguyen, Raman Tanwar, Edson Borges Junior, Ashok Agarwal","doi":"10.5534/wjmh.250037","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Non-obstructive azoospermia (NOA), defined as the absence of sperm in the ejaculate due to testicular failure, is observed in 5% to 15% of infertile men and accounts for two-thirds of azoospermia cases. The management of NOA is marked by significant controversy and global variation in diagnostic and therapeutic approaches, highlighting the crucial need for well-designed and standardized clinical practice guidelines. We present comprehensive graded clinical practice recommendations and statements for diagnosing and treating NOA, aiming to establish standardized strategies that can globally help guide practitioners in their practice.</p><p><strong>Materials and methods: </strong>A comprehensive literature review was conducted to gather evidence on the epidemiological, diagnostic, and therapeutic aspects of NOA. The Global Andrology Forum (GAF) recommendations were developed through the collaboration of a global panel of experts using the Delphi method and surveys to achieve consensus. Statements were graded according to the Oxford Centre for Evidence-Based Medicine \"GRADE\" classification as either \"Strong\" or \"Weak.\" Statements receiving at least 80% expert consensus were graded as \"Strong,\" while others were categorized as \"Weak.\"</p><p><strong>Results: </strong>The GAF has formulated a total of 49 recommendations and statements on the diagnosis and treatment of NOA, including 21 for diagnosis and 28 for treatment. The recommendations and statements were evaluated and graded by a panel of 48 GAF experts from 25 countries worldwide. The majority of experts (60.5%) had more than 10 years of clinical experience in managing NOA.</p><p><strong>Conclusions: </strong>The GAF guidelines address discrepancies in NOA management across diverse clinical settings and provide comprehensive graded recommendations to guide clinicians in its diagnosis and treatment. Developed and graded by a large worldwide panel of experts, the current guidelines present simplified, high-standard strategies that can be seamlessly integrated into the daily global practice, offering practitioners a clear framework for managing NOA.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Global Andrology Forum (GAF) Clinical Guidelines on the Management of Non-obstructive Azoospermia: Bridging the Gap between Controversy and Consensus.\",\"authors\":\"Taha Hamoda, Rupin Shah, Taymour Mostafa, Germar-Michael Pinggera, Widi Atmoko, Amarnath Rambhatla, Manaf Al Hashimi, Selahittin Çayan, Giovanni Maria Colpi, Hiva Alipour, Edmund Ko, Armand Zini, Fotios Dimitriadis, Ayman Rashed, Hyun Jun Park, Ramadan Saleh, Tuncay Toprak, Aleksei Ryzhkov, Ateş Kadıoğlu, Hussein Kandil, Arif Kalkanli, Ahmed I El-Sakka, Gokhan Calik, Marco Falcone, Haitham Elbardisi, Mohamed Arafa, Christopher Chee Kong Ho, Marlon Pedrozo Martinez, Saleh Binsaleh, Ahmad Tarek Motawi, Nazim Gherabi, Akira Tsujimura, Hisanori Taniguchi, Raghavender Kosgi, Aldo E Calogero, Taras Shatylko, Dongsuk Kim, Charalampos Thomas, Nicholas N Tadros, Sotiris Andreadakis, Muhammad Ujudud Musa, Charalampos Konstantinidis, Mirko Preto, Tan V Le, Kareim Mohamed Khalafalla, Rossella Cannarella, Kasonde Bowa, Balasingam Balagobi, Darren Jonathan Katz, Quang Nguyen, Raman Tanwar, Edson Borges Junior, Ashok Agarwal\",\"doi\":\"10.5534/wjmh.250037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Non-obstructive azoospermia (NOA), defined as the absence of sperm in the ejaculate due to testicular failure, is observed in 5% to 15% of infertile men and accounts for two-thirds of azoospermia cases. The management of NOA is marked by significant controversy and global variation in diagnostic and therapeutic approaches, highlighting the crucial need for well-designed and standardized clinical practice guidelines. We present comprehensive graded clinical practice recommendations and statements for diagnosing and treating NOA, aiming to establish standardized strategies that can globally help guide practitioners in their practice.</p><p><strong>Materials and methods: </strong>A comprehensive literature review was conducted to gather evidence on the epidemiological, diagnostic, and therapeutic aspects of NOA. The Global Andrology Forum (GAF) recommendations were developed through the collaboration of a global panel of experts using the Delphi method and surveys to achieve consensus. Statements were graded according to the Oxford Centre for Evidence-Based Medicine \\\"GRADE\\\" classification as either \\\"Strong\\\" or \\\"Weak.\\\" Statements receiving at least 80% expert consensus were graded as \\\"Strong,\\\" while others were categorized as \\\"Weak.\\\"</p><p><strong>Results: </strong>The GAF has formulated a total of 49 recommendations and statements on the diagnosis and treatment of NOA, including 21 for diagnosis and 28 for treatment. The recommendations and statements were evaluated and graded by a panel of 48 GAF experts from 25 countries worldwide. The majority of experts (60.5%) had more than 10 years of clinical experience in managing NOA.</p><p><strong>Conclusions: </strong>The GAF guidelines address discrepancies in NOA management across diverse clinical settings and provide comprehensive graded recommendations to guide clinicians in its diagnosis and treatment. Developed and graded by a large worldwide panel of experts, the current guidelines present simplified, high-standard strategies that can be seamlessly integrated into the daily global practice, offering practitioners a clear framework for managing NOA.</p>\",\"PeriodicalId\":54261,\"journal\":{\"name\":\"World Journal of Mens Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Mens Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5534/wjmh.250037\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANDROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Mens Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5534/wjmh.250037","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANDROLOGY","Score":null,"Total":0}
Global Andrology Forum (GAF) Clinical Guidelines on the Management of Non-obstructive Azoospermia: Bridging the Gap between Controversy and Consensus.
Purpose: Non-obstructive azoospermia (NOA), defined as the absence of sperm in the ejaculate due to testicular failure, is observed in 5% to 15% of infertile men and accounts for two-thirds of azoospermia cases. The management of NOA is marked by significant controversy and global variation in diagnostic and therapeutic approaches, highlighting the crucial need for well-designed and standardized clinical practice guidelines. We present comprehensive graded clinical practice recommendations and statements for diagnosing and treating NOA, aiming to establish standardized strategies that can globally help guide practitioners in their practice.
Materials and methods: A comprehensive literature review was conducted to gather evidence on the epidemiological, diagnostic, and therapeutic aspects of NOA. The Global Andrology Forum (GAF) recommendations were developed through the collaboration of a global panel of experts using the Delphi method and surveys to achieve consensus. Statements were graded according to the Oxford Centre for Evidence-Based Medicine "GRADE" classification as either "Strong" or "Weak." Statements receiving at least 80% expert consensus were graded as "Strong," while others were categorized as "Weak."
Results: The GAF has formulated a total of 49 recommendations and statements on the diagnosis and treatment of NOA, including 21 for diagnosis and 28 for treatment. The recommendations and statements were evaluated and graded by a panel of 48 GAF experts from 25 countries worldwide. The majority of experts (60.5%) had more than 10 years of clinical experience in managing NOA.
Conclusions: The GAF guidelines address discrepancies in NOA management across diverse clinical settings and provide comprehensive graded recommendations to guide clinicians in its diagnosis and treatment. Developed and graded by a large worldwide panel of experts, the current guidelines present simplified, high-standard strategies that can be seamlessly integrated into the daily global practice, offering practitioners a clear framework for managing NOA.
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