Azoospermia is a condition that threatens an individual’s or a couple’s hope in their journey to realize their dream of having children. In certain situations, such as azoospermia caused by genetic abnormalities or the absence of both testicles, the hope of having biological children is clearly lost. Based on its causes, azoospermia is divided into two types: obstructive azoospermia (OA) and nonobstructive azoospermia (NOA), with NOA being more common and more concerning Hormonal imbalance is suspected to be one of the causes of NOA because a good balance and production of hormones involved in the hypothalamic–pituitary–gonadal (HPG) axis are required for the spermatogenesis process. Some hormones involved in this process include gonadotropin-releasing hormone (GnRH), testosterone, prolactin, estradiol, sex hormone-binding globulin (SHBG), inhibin B, anti-Mullerian hormone (AMH), and leptin. Clinicians’ ability to understand the functions of these hormones individually can serve as a basis for making a diagnosis and determining the next steps needed before proceeding to surgical sperm retrieval (SSR), which is typically the final step in NOA cases.