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

## TL;DR

A man with non-obstructive azoospermia was later diagnosed with kidney failure, showing that infertility can signal broader health issues.

## Contribution

This case report links non-obstructive azoospermia to focal segmental glomerulosclerosis and chronic kidney disease.

## Key findings

- Elevated creatinine in blood tests led to a diagnosis of end-stage renal disease in a patient with NOA.
- Semen analysis after kidney transplantation showed cryptozoospermia, indicating partial recovery of spermatogenesis.
- The case suggests NOA may be a silent indicator of systemic diseases like kidney failure.

## Abstract

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.

•Infertility is a significant healthcare concern beyond reproduction.•Managing male infertility should address overall health and life expectancy.•Comorbidities linked to infertility impact both reproductive and general health.•Recognizing these comorbidities-infertility interactions will enhance patient care and therapeutic advancements.

Infertility is a significant healthcare concern beyond reproduction.

Managing male infertility should address overall health and life expectancy.

Comorbidities linked to infertility impact both reproductive and general health.

Recognizing these comorbidities-infertility interactions will enhance patient care and therapeutic advancements.