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Abstract Approximately 15% of couples are unable to conceive after one year of unprotected intercourse. A male factor is solely responsible in about 20% of infertile couples and contributory in another 30-40 %. Infertility already affects about 5-7% of the general male population and may further increase in the future, considering the apparent trend of declining sperm count in industrialized countries. The purpose of this study is to asses the Hormonal changes in men suffering from non obstructive azoospermia and secondary infertility. Patients with NOA where subjected to evaluation of hormonal profile mainly FSH&LH (factors such as: age , smoking, CVD, diabetes and varicocele are considered in our study ) The levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and total testosterone (TT) in the plasma of positive and negative TESE cases are evaluatedThe levels of FSH and LH in the plasma of TESE negative cases were significantly (P<0.05) greater than those in TESE positive cases. On the other hand, no significant difference in the TT levels were observed between the TESE negative and positive cases. About 66.7% of negative TESE cases and 61.9% of positive ones had TT levels greater than 2 mU/mL of plasma .the association of TESE score with the varicocele level, smoking and diabetes mellitus incidence were estimated. TESE score was dependent on smoking. 88.2% of the non-smoker exhibited positive TESE score. In contrast, 53.8% of the smokers were negative TESE cases. Although there was no significant association between varicocele and TESE score, by increasing the severity of varicocele, the percentage of negative TESE cases was markedly elevated.The TESE score was independent on the incidence of diabetes. The highest percentages of diabetic (80%) and non-diabetic (60%) cases had positive TESE scores |