The first Congress of the Global Andrology Forum was held in collaboration with the Turkish Society of Andrology National Congress on May 23-24, 2025, in Fethiye, Türkiye.
FIRST SESSION: MASTERCLASS ON MANAGEMENT OF NON-OBSTRUCTIVE AZOOSPERMIA
The Masterclass was moderated by Professors Jonathan Ramsay from the United Kingdom and Giovanni M. Colpi from Switzerland. This high-level session provided an in-depth, multidisciplinary exploration of the complex etiology and management strategies for non-obstructive azoospermia (NOA). The program featured expert presentations on the following key topics:
• Genetic Testing for NOA – Aleksei Ryzhkov, Russia.
• Hormonal Therapy Prior to Sperm Retrieval – Barış Altay, Türkiye.
• The Role of Varicocele Surgery in NOA – Mohamed S. Al-Marhoon, Oman.
• Current Indications for FNA Mapping Before Surgical Sperm Retrieval – Jonathan Ramsay, United Kingdom.
• Advantages and Disadvantages of ICSI using Frozen Versus Fresh Surgically Retrieved Sperm -Jonathan Ramsay, United Kingdom
• Techniques for Safe and Effective mTESE – Giovanni M. Colpi, Switzerland.
• Is mTESE the Sole Surgical Option for NOA? – Marlon Martinez, Philippines
• Management of failed microTESE cases – Ayman Rashed, Egypt
• Predictive Factors for Successful Sperm Retrieval in NOA: Current and Future Perspectives – Emad Abdelraheem Taha, Egypt.
Each speaker delivered evidence-based analyses, addressed current controversies in the literature, and highlighted directions for future research. The session upheld a high standard of scientific rigor, critical discourse, and intellectual engagement.
Despite time constraints, each talk was followed by an interactive question-and-answer session that facilitated meaningful exchanges with an international audience of distinguished experts. These discussions significantly enhanced the academic dialogue and underscored the translational relevance of the findings presented. The session structure was clinically valuable.
Each presentation represented a step in the management of Non-Obstructive Azoospermia, which has structural, medical, genetic, and critical psychological aspects. Each speaker explored a dilemma or point of debate in the pathway and related it to the GAF guidelines, a digest of best practices informed but not dominated by existing publications from Andrological and Urological Societies.
We believe the delegates gained a clearer understanding of several debated options, as the roles of Varicocele and medical treatments were thoroughly explored in relation to female age and the timing of MicroTESE. The superiority of MicroTESE was in no doubt, but the importance of support from skilled, patient laboratory staff was underscored. The possible value of testicular mapping by fine needle aspiration (FNA) was discussed as a diagnostic adjunct to delayed successful MicroTESE synchronized with oocyte retrieval (if we suspect that there is a slightly better LBR with fresh, not cryopreserved, sperm). Finally, the importance of genetic evaluation using existing Karyotype and Y chromosome analyses was reiterated and clarified, leading to greater awareness of the need for more comprehensive Exome and Genome testing in the future.
