Rupin Shah, Amarnath Rambhatla, Widi Atmoko, Marlon Martinez, Imad Ziouziou, Priyank Kothari, Nicholas Tadros, Nguyen Ho Vinh Phuoc, Parviz Kavoussi, Ahmed Harraz, Gianmaria Salvio, Murat Gul, Taha Hamoda, Tuncay Toprak, Ponco Birowo, Edmund Ko, Mohamed Arafa, Ramy Abou Ghayda, Vilvapathy Senguttuvan Karthikeyan, Ramadan Saleh, Giorgio Ivan Russo, Germar-Michael Pinggera, Eric Chung, Missy Savira, Giovanni M. Colpi, Wael Zohdy, Edoardo Pescatori, Hyun Jun Park, Shinichiro Fukuhara, Akira Tsujimura, Cesar Rojas-Cruz, Angelo Marino, Siu King Mak, Edouard Amar, Wael Ibrahim, Puneet Sindhwani, Naif Alhathal, Gian Maria Busetto, Manaf Al Hashimi, Ahmed El-Sakka, Asci Ramazan, Fotios Dimitriadis, Massimiliano Timpano, Davor Jezek, Baris Altay, Daniel Suslik Zylbersztejn, Michael Y.C. Wong, Du Geon Moon, Christine Wyns, Safar Gamidov, Hamed Akhavizadegan, Alessandro Franceschelli, Kaan Aydos, Vinh Nguyen Quang, Shedeed Ashour, Adel Al Dayel, Mohamed S. Al-Marhoon, Sava Micic, Saleh Binsaleh, Alayman Hussein, Haitham Elbardisi, Taymour Mostafa, Emad Taha, Jonathan Ramsay, Athanasios Zachariou, Islam Fathy Soliman Abdelrahman, Osvaldo Rajmil, Arif Kalkanli, Juan Manuel Corral Molina, Kadir Bocu, Gede Wirya Kusuma Duarsa, Gokhan Ceker, Ege Can Serefoglu, Fahmi Bahar, Nazim Gherabi, Shinnosuke Kuroda, Abderrazak Bouzouita, Ahmet Gudeloglu, Erman Ceyhan, Mohamed Saeed Mohamed Hasan, Muhammad Ujudud Musa, Ahmad Motawi, Cho Chak-Lam, Hisanori Taniguchi, Christopher Chee Kong Ho, Jesus Fernando Solorzano Vazquez, Shingai Mutambirwa, Nur Dokuzeylul Gungor, Marion Bendayan, Carlo Giulioni, Aykut Baser, Marco Falcone, Luca Boeri, Gideon Blecher, Alireza Kheradmand, Tamilselvi Sethupathy, Ricky Adriansjah, Nima Narimani, Charalampos Konstantinidis, Tuan Thanh Nguyen, Andrian Japari, Parisa Dolati, Keerti Singh, Cevahir Ozer, Selcuk Sarikaya, Nadia Sheibak, Ndagijimana Jean Bosco, Mehmet Serkan Özkent, Sang Thanh Le, Ioannis Sokolakis, Darren Katz, Ryan Smith, Manh Nguyen Truong, Tan V. Le, Zhongwei Huang, Muslim Dogan Deger, Umut Arslan, Gokhan Calik, Giorgio Franco, Ayman Rashed, Oguzhan Kahraman, Sotiris Andreadakis, Rosadi Putra, Giancarlo Balercia, Kareim Khalafalla, Rossella Cannarella, Anh Đang Tuan, Amr El Meliegy, Birute Zilaitiene, Marlene Lizbeth Zamora Ramirez, Filippo Giacone, Aldo E. Calogero, Konstantinos Makarounis, Sunil Jindal, Bac Nguyen Hoai, Ravi Banthia, Marcelo Rodriguez Peña, Dharani Moorthy, Aram Adamyan, Deniz Kulaksiz, Hussein Kandil, Nikolaos Sofikitis, Ciro Salzano, Andreas Jungwirth, Surendra Reddy Banka, Tiago Cesar Mierzwa, Tahsin Turunç, Divyanu Jain, Armen Avoyan, Pietro Salacone, Ateş Kadıoğlu, Chirag Gupta, Haocheng Lin, Iman Shamohammadi, Nasser Mogharabian, Trenton Barrett, Yavuz Onur Danacıoğlu, Andrea Crafa, Salima Daoud, Vineet Malhotra, Abdulmalik Almardawi, Osama Mohamed Selim, Mohamad Moussa, Saeid Haghdani, Mesut Berkan Duran, Yannic Kunz, Mirko Preto, Elena Eugeni, Thang Nguyen, Ahmed Rashad Elshahid, Seso Sulijaya Suyono, Dyandra Parikesit, Essam Nada, Eduardo Gutiérrez Orozco, Florence Boitrelle, Nguyen Thi Minh Trang, Mounir Jamali, Raju Nair, Mikhail Ruzaev, Franco Gadda, Charalampos Thomas, Raphael Henrique Ferreira, Umit Gul, Serena Maruccia, Ajay Kanbur, Ella Kinzikeeva, Saad Abumelha, Nguyen Quang, Raghavender Kosgi, Fatih Gokalp, Mohammad Ayodhia Soebadi, Gustavo Marquesine Paul, Hesamoddin Sajadi, Deepak Gupte, Rafael F. Ambar, Emrullah Sogutdelen, Karun Singla, Ari Basurkano, Shannon Hee Kyung Kim, Mohammad Ali Sadighi Gilani, Koichi Nagao, Sakti Ronggowardhana Brodjonegoro, Andri Rezano, Mohamed Elkhouly, Rossella Mazzilli, Hasan M.A. Farsi, Hung Nguyen Ba, Hamed Alali, Dimitrios Kafetzis, Tran Quang Tien Long, Sami Alsaid, Hoang Bao Ngoc Cuong, Knigavko Oleksandr, Akhmad Mustafa, Herik Acosta, Hrishikesh Pai, Bahadır Şahin, Eko Arianto, Colin Teo, Sanjay Prakash Jayaprakash, Rinaldo Indra Rachman, Mustafa Gurkan Yenice, Omar Sefrioui, Smit Paghdar, Shivam Priyadarshi, Marko Tanic, Noor Kareem Alfatlawy, Fikri Rizaldi, Ranjit B. Vishwakarma, George Kanakis, Dinesh Thomas Cherian, Joe Lee, Raisa Galstyan, Hakan Keskin, Jana Wurzacher, Doddy Hami Seno, Bambang S. Noegroho, Ria Margiana, Qaisar Javed, Fabrizio Castiglioni, Raman Tanwar, Ana Puigvert, Coşkun Kaya, Medianto Purnomo, Chadi Yazbeck, Azwar Amir, Edson Borges, Marina Bellavia, Isaac Ardianson Deswanto, K.V. Vinod, Giovanni Liguori, Dang Hoang Minh, Kashif Siddiqi, Fulvio Colombo, Armand Zini, Niket Patel, Selahittin Çayan, Ula Al-Kawaz, Maged Ragab, Guadalupe Hernández Hebrard, Ivan Hoffmann, Ozan Efesoy, Barış Saylam, Ashok Agarwal
Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations. Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations. Copyright © 2024 Korean Society for Sexual Medicine and Andrology.
Global Andrology Forum, 130 West Juniper Lane, Moreland Hills, 44022, OH, United States; Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India; Global Andrology Forum, Moreland Hills, OH, United States; Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, United States; Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines; Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco; Department of Urology, B.Y.L Nair Ch Hospital, Topiwala National Medical College, Mumbai, India; Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, United States; Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Viet Nam; Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, United States; Department of Urology, Mansoura University Urology and Nephrology Center, Mansoura, Egypt; Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait; Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait; Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy; Department of Urology, Selçuk University School of Medicine, Konya, Turkey; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Andrology, Faculty of Medicine, Assiut University, Asyut, Egypt; Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey; Department of Urology, Loma Linda University Health, Loma Linda, CA, United States; American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, United States; Department of Urology, Hamad Medical Corporation, Doha, Qatar; Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar; Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, United States; Andrology Unit, Department of Urology, Apollo Hospitals, Greams Road, Chennai, India; Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt; Urology Section, University of Catania, Catania, Italy; Department of Urology, University Hospital Innsbruck, Innsbruck, Austria; Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia; Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland; Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt; Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy; Department of Urology, Pusan National University School of Medicine, Busan, South Korea; Medical Research Institute of Pusan National University Hospital, Busan, South Korea; Department of Urology, Graduate School of Medicine, Osaka University, Japan; Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Urology, University Hospital of Rostock, Rostock, Germany; Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Palermo, Italy; Union Hospital, Hong Kong; Department of Urology, American Hospital of Paris, Paris, France; Department of Obstetrics Gynaecology and Reproductive Medicine, Fertility Care Center in Cairo, Cairo, Egypt; Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy; Department of Urology, Burjeel Hospital, Abu Dhabi, United Arab Emirates; Department of Urology, Khalifa University College of Medicine and Health Science, Abu Dhabi, United Arab Emirates; Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; Department of Urology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey; 1st Urology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy; Department for Transfusion Medicine and Transplantation Biology, Reproductive Tissue Bank, University of Zagreb School of Medicine, Zagreb, Croatia; Department of Urology, Ege University Medical School, Bornova, Izmir, Turkey; Department of Urology, Fleury Group, Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Andrology, International Urology, Fertility and Gynecology Centre, Mount Elizabeth Hospital, Singapore; Department of Urology, Korea University Guro Hospital, Seoul, South Korea; Department of Gynaecology-Andrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russian Federation; Department of Urology, School of Medicine, Hasheminejad Kidney Center, Iran University of Medical Science, Tehran, Iran; Andrology Unit, University Hospital S. Orsola, Bologna, Italy; Department of Urology, Ankara University, Ankara, Turkey; Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Viet Nam; Department of Urology, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Viet Nam; Men's Health Clinic Dammam, Dammam, Saudi Arabia; Division of Urology, Department of Surgery, Sultan Qaboos University, Muscat, Oman; Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia; Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Andrology, Hammersmith Hospital, London, United Kingdom; Department of Urology, Ioannina University School of Medicine, Ioannina, Greece; Department of Andrology, Armed Forces College of Medicine, Cairo, Egypt; Department of Andrology, Fundacio Puigvert, Barcelona, Spain; Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey; Department of Urology, Hospital Clínico de Barcelona, Barcelona, Spain; Department of Urology, Niğde Omer Halis Demir University Faculty of Medicine, Nigde, Turkey; Department of Urology, Udayana University, Denpasar, Indonesia; Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey; Department of Urology, Biruni University School of Medicine, Istanbul, Turkey; Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia; Department of Medicine, University of Algiers 1, Algiers, Algeria; Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, United States; Department of Anatomy, Faculty of Medicine, Faculty Tunis Manar, Tunis, Tunisia; Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey; Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Urology Unit, Department of Surgery, Federal Medical Center, Katsina State, Nigeria; Department of Surgery, S. H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong; Department of Urology and Andrology, Kansai Medical University, Osaka, Japan; Department of Surgery, School of Medicine, Taylor's University, Selangor, Malaysia; IVF Department, CITMER Reproductive Medicine, Mexico City, Mexico; Department of Urology, Dr. George Mukhari Academic Hospital, Sefako Makgatho Health Science University, Medunsa, South Africa; Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey; Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France; Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France; Department of Urology, Polytechnic University of Marche, Ancona, Italy; Department of Urology, Faculty of Medicine, Bandırma Onyedi Eylül University, Balıkesir, Turkey; Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia; Department of Urology, The Alfred Hospital, Melbourne, Australia; Department of Urology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Obstetrics and Gynaecology, CK Medical Centre Hospital, Erode, India; Department of Urology, Hasan Sadikin General Hospital, Faculty of Medicine of Padjadjaran University, Bandung, Indonesia; Urology Department, General Hospital of Corinth, Corinth, Greece; Department of Urology, University of California, Irvine, CA, United States; Department of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam; Department of Urology, Cho Ray Hospital, Ho Chi Minh City, Viet Nam; Deparment of IVF, Fertility Clinic, Telogorejo Hospital, Semarang, Indonesia; Department of Animal Science, Faculty of Agriculture, University of Shiraz, Shiraz, Iran; Department of Preclinical and Health Sciences, Faculty of Medical Sciences, The University of West Indies, Cave Hill Campus, Bridgetown, Barbados; Windsor Medical Centre, Bridgetown, Barbados; Department of Urology, Gulhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey; Department of Anatomical Sciences, Reproductive Sciences and Technology Research Center, Iran University of Medical Sciences, Tehran, Iran; Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran; Department of Dermatology, Venereology & Andrology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt; Department of Urology, Konya City Hospital, Konya, Turkey; Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany; Men's Health Melbourne, Australia; Department of Surgery, Western Precinct, University of Melbourne, Australia; Department of Urology, Western Health, VIC, Australia; Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, United States; Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam; Department of Obstetrics and Gynaecology, National University Health Systems, Singapore; Department of Urology, Edirne Sultan 1st Murat State Hospital, Edirne, Turkey; Department of Urology, Istanbul Medipol University, Istanbul, Turkey; Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy; Department of Urology, Faculty of Medicine, 6th of October University, Giza, Egypt; Private Practice, Thessaloniki, Greece; Department of Urology, RSUD Ciawi Regional General Hospital, West Java, Indonesia; Department of Urology, University of Illinois, Chicago, IL, United States; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Tam Anh IVF Center, Tam Anh General Hospital, Hanoi, Viet Nam; Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Reproductive Medicine Unit, Español Hospital, Mexico City, Mexico; HERA Center, Unit of Reproductive Medicine, Sant'Agata Li Battiati, Catania, Italy; Department of Urology and Andrology, Locus Medicus, Athens, Greece; Department of Andrology & Reproductive Medicine, Jindal Hospital & Fertility Center, Meerut, India; Department of Andrology and Sexual Medicine, Hanoi Medical University Hospital, Hanoi, Viet Nam; Department of Urology, Western General Hospital, Edinburgh, United Kingdom; Instituto de Ginecología y Fertilidad (IFER), Universidad de Buenos Aires, Buenos Aires, Argentina; IVF Department, Swarupa fertility & IVF Centre, Vijayawada, India; Department of Urology, Astghik Medical Center, Yerevan, Armenia; Department of Obstetrics and Gynecology, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey; Fakih IVF Fertility Center, Abu Dhabi, United Arab Emirates; PO San Giovanni Bosco, ASL Napoli 1 Centro, Napoli, Italy; St. Barabara Private Clinic, Bad Vigaun, Austria; Department of Andrology, Androcare Institute of Andrology and Men's Health, Hyderabad, India; Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil; Urology Clinic, Iskenderun Gelisim Hospital, Iskenderun, Turkey; Department of Obstetrics and Gynecology, Jaipur Golden Hospital, New Delhi, India; Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy; Section of Andrology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; Department of Urology, Jaipur National University, Jaipur, India; Department of Urology, Peking University Third Hospital, Peking University, Beijing, China; Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran; Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran; Perth Urology Clinic, Perth, WA, Australia; Department of Urology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Science Istanbul, Istanbul, Turkey; Laboratory of Histo-Embryology and Reproductive Biology, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia; Department of Urology and Andrology, VNA Hospital, New Delhi, India; Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; Department of Urology, Lebanese University, Beirut, Lebanon; Department of Urology, Al Zahraa Hospital, UMC, Beirut, Lebanon; Andrology Research Center, Yazd Reproductive Science Institute, Isfahan Fertility and Isfahan, Yazd, Iran; Department of Urology, Pamukkale University School of Medicine, Denizli, Turkey; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Department of Medicine and Medical Specialties, Division of Medical Andrology and Endocrinology of Reproduction, University of Terni, Terni, Italy; Gladiool IVF, Magelang, Indonesia; Department of Urology, Universitas Indonesia Hospital, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia; IVF Department, CITMER Reproductive Medicine, Nuevo Leon, Mexico; Department of Urology, Military Teaching Hospital, Rabat, Morocco; Department of Reproductive Medicine, Mitera Hospital, Kottayam, India; Urology Clinic, Moscow, Russian Federation; Department of Urology, Santa Casa de Ribeirão Preto, São Paulo, Brazil; Private EPC Hospital, Adana, Turkey; Department of Urology, ASST Santi Paolo e Carlo, San Paolo Hospital, Milano, Italy; Department of Andrology, Kanbur Clinic, Thane, India; Department of Urosurgery, Jupiter Hospital, Thane, India; Zucchi Clinical Institutes, Monza, Italy; Department of Urology and Andrology, AIG Hospitals, Hyderabad, India; Department of Urology, Faculty of Medicine, Hatay Mu Stafa Kemal University, Antakya, Turkey; Department of Urology, Faculty of Medicine, Universitas Airlangga, Soetomo Hospital, Surabaya, Indonesia; Department of Urology, Hospital de Clínicas, the Federal University of Paraná, Curitiba, Brazil; Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Urology, Bombay Hospital and Medical Research Center, Mumbai, India; Department of Urology, Clarity Health, Chandigarh, India; Department of Urology, Dr. Dradjat Hospital, Serang, Indonesia; IVF Australia, Sydney, Australia; Macquarie School of Medicine, Macquaire University, Sydney, Australia; Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom; Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan; Division of Urology, Department of Surgery, Prof. Dr. Sardjito Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia; Andrology Study Program, Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia; IVF Department, Bourn Hall Fertility Center, Dubai, United Arab Emirates; Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy; Andrology Unit, ART Center, Vinmec Times City International Hospital, Hanoi, Viet Nam; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Orchid IVF Clinic, Dubai, United Arab Emirates; Department of Obstetrics and Gynecology, Hanoi Obstetric and Gynecology Hospital, Hanoi, Viet Nam; Department of Surgery, Hai Phong University of Medicine and Pharmacy, Hai Phong, Viet Nam; Department of Urology, Nephrology and Andrology, Kharkiv National Medical University, Kharkiv, Ukraine; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan; IVF Department, Bloom IVF Group, Mumbai, India; Department of Urology, School of Medicine, Marmara University, İstanbul, Turkey; Department of Urology, Prof R.D. Kandou Hospital, Manado, Indonesia; Department of Urology, Gleneagles Hospital, Singapore; African Fertility Center, Casablanca, Morocco; UVA Urology Clinic in Charlottesville, UVA Specialty Care Clinic in Culpeper, Culpeper, VA, United States; Department of Urology, Sawai Man Singh Medical College and Hospital, Rajasthan, Jaipur, India; Department of Urology, General Hospital, Cuprija, Serbia; Fertility Center of Al-Najaf/Al-Sadr Medical City, Babylon Health Directorate, Iraqi Ministry of Health, Baghdad, Iraq; Department of Endocrinology, Diabetes and Metabolism, Athens Naval & VA Hospital, Athens, Greece; Urology Deparment, Aster Medcity, Kochi, India; Department of Urology, National University Hospital, Singapore; Department of Urology, Yerevan State Medical University, Yerevan, Armenia; Division of Urology, Department of Surgery, Persahabatan General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Department of Urology, Al-Ahlia Hospital, Abu Dhabi, United Arab Emirates; Andrology Unit, ART Center - San Carlo Clinic, Milan, Italy; Urology Center, Jyoti Hospital, Gurugram, India; Institute of Andrology and Sexual Medicine (IANDROMS), Barcelona, Spain; Department of Urology, Health Science University Eskisehir City HPRH, Eskisehir, Turkey; Department of Urology, Brawijaya University, Malang, Indonesia; Department of Obstetrics Gynecology and Reproductive Medicine, Reprogynes Medical Institute, Paris, France; Department of Urology, Dr Wahidin Sudirohusodo Hospital, Makassar, Indonesia; Fertility Assisted Fertilization Center, São Paulo, Brazil; Department of Urology, Cure & SK Hospital, Trivandrum, India; Department of Urology, University of Trieste, Trieste, Italy; Department of Urology, Cleveland Clinic, Abu Dhabi, United Arab Emirates; Department of Surgery, McGill University, Montreal, QC, Canada; Akanksha Hospital and Research Institute, Gujarat, Anand, India; Department of Urology, University of Mersin School of Medicine, Mersin, Turkey; High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq; Department of Urology, Tanta University, Tanta, Egypt; IVF Department, CITMER Reproductive Medicine, Puebla, Mexico; Department of Reproductive Medicine and Andrology, University Clinic Halle, Saale, Germany; Reproductive Center Dr. Hoffmann, Berlin, Germany; Department of Urology, Mersin City Training and Research Hospital, University of Health Sciences, Mersin, Turkey