The purpose of this study is to assess a potential association between reproductive hormone levels and testicular volumes with testicular biopsy in men with non-obstructive azoospermia (NOA) undergoing testicular sperm extraction (TESE). The complete records of 100 azoospermia men without clinical evidence of obstructive etiologies who underwent TESA. Preoperative diagnostic biopsies were not obtained and thus men with presumed NOA were defined as having no evidence of obstruction by history or physical examination. Preoperative FSH, LH and testosterone were obtained for all patients and bilateral testicular volume was determined to find the correlation between probabilities of positive sperm extraction with TESE. Two subgroups of NOA were evaluated (Group 1 TESE and Group 2 Fresh ejaculated). Results: There were significant differences in FSH, levels, in group 2 compared to group 1, and no significant differences in LH, PRL, Testosterone, and E2. Furthermore, no significant differences in right testicular volume, and left testicular volume in the two groups. The success rate of TESE was decreased when increased FSH and LH levels. In NOA cases increased FSH and LH levels, and decreased testis volumes have a negative effect on sperm retrieval but small testicular volumes only can present sperm retrieval.