Introduction: We previously reported an increase in the age of men with nonobstructive azoospermia (NOA) (AUA Annual Meeting 2020). It is important to determine age-induced effects on testicular function in men with NOA. We investigated age-induced changes in testicular endocrine function and the sperm retrieval rate (SRR) during microdissection testicular sperm extraction in men with NOA. Methods: We investigated 323 men with idiopathic NOA. Patients were categorized into the following age-based groups: 20s (20–30 years, n=64), 30s (30–40 years, n=201), and >40s (>40 years, n=58). We retrospectively recorded testicular volume, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), and anti-Mullerian hormone (AMH) levels, and SRRs. Results: Testicular volumes in groups 20s, 30s, and >40s were 9.5±4.3 vs. 9.1±4.0 vs. 7.9±3.9 mL, p<0.05 (Jonckheere-Terpstra trend test). Although we observed no intergroup differences in serum LH and TT levels, FSH levels significantly increased with age (22.4±13.3 vs. 26.9±13.2 vs. 26.8±15.3 mIU/mL, p<0.05) as did serum AMH levels (4.4±4.3 vs. 7.9±6.3 vs. 9.2±7.0 ng/mL, p<0.01). SRRs in the 20s, 30s, and 40s groups were 12.5 vs. 28.4 vs. 36.2%, p<0.05 (Cochran-Armitage trend test). Conclusions: We observed age-induced testicular atrophy and increased serum FSH and AMH levels, which highlight age-induced testicular function decline in men with NOA and suggest that NOA may be progressive despite favorable SRRs in older men. SOURCE OF Funding: none
