JCOGP
Journal of Controversies in Obstetrics & Gynecology and Pediatrics

As of January 2023, our "Journal of Controversies Obstetrics & Gynecology and Pediatrics" has been published under the Medihealth Academy to publish all articles, reviews and case reports on Pediatrics, especially in the field of Obstetrics and Gynecology. In order to facilitate the citation of the articles, to take our place in internationally respected indexes and to reach a wider readership, we will pay attention to the fact that our article language is only English in terms of acceptance. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-0579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Review
Male infertility: an overview of etiology, diagnosis and management
Abstract
Male infertility, a multifaceted condition characterized by the inability to achieve pregnancy within a partner after a year of unprotected intercourse, affects approximately 7% of men globally. The etiology of male infertility is diverse, including genetic abnormalities, hormonal imbalances, physical obstructions, and lifestyle factors. This review synthesizes current knowledge on the causes, diagnostic methods, and therapeutic interventions for male infertility, with an emphasis on recent advances in genetic and assisted reproductive technologies (ART). The diagnostic approach to male infertility involves a comprehensive evaluation, including semen analysis, hormonal profiling, genetic testing, and imaging techniques, to identify underlying causes. Management strategies range from lifestyle modifications and pharmacological treatments to surgical interventions and ART, such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Emerging technologies, including the use of artificial intelligence in semen analysis and the development of novel sperm retrieval techniques, promise to enhance diagnostic accuracy and treatment outcomes. Despite significant progress, challenges remain in improving access to care and addressing ethical considerations in the use of ART. This review highlights the importance of a multidisciplinary approach to the management of male infertility, integrating advances in medical science with considerations of patient well-being and ethical standards. Future research directions include elucidating the genetic basis of idiopathic male infertility, optimizing ART outcomes, and developing personalized treatment strategies. The ultimate goal is to improve the reproductive health and quality of life for affected individuals and couples.

Keywords : Male infertility, semen analysis, assisted reproductive technology, genetic abnormalities, hormonal imbalances, lifestyle factors

Download Article


1. WHO. Infertility: A global public health issue. 2020.
2. Harlow AF, Zheng A, Nordberg J, Hatch EE, Ransbotham S, Wise LA.A qualitative study of factors influencing male participation in fertilityresearch.Reprod Health. 2020;17(1):186. doi: 10.1186/s12978-020-01046-y
3. Jarow JP, Sharlip ID, Belker AM, et al. Best practice policies for maleinfertility.J Urol. 2002;167(5):2138-2144.
4. Barratt CLR, Björndahl L, De Jonge CJ, et al. The diagnosis of maleinfertility: an analysis of the evidence to support the developmentof global WHO guidance-challenges and future researchopportunities.Hum Reprod Update. 2017;23(6):660-680. doi: 10.1093/humupd/dmx021
5. Biggs SN, Kennedy J, Lewis SL, et al. Lifestyle and environmental riskfactors for unexplained male infertility: study protocol for AustralianMale Infertility Exposure (AMIE), a case-control study.Reprod Health.2023;20(1):32. doi: 10.1186/s12978-023-01578-z
6. McLachlan RI, O’Bryan MK. State of the art for genetic testing ofinfertile men.J Clin Endocrinol Metab. 2010;95(3):1013-1024. doi:10.1210/jc.2009-1925
7. Schmidt L. Psychosocial burden of infertility and assistedreproduction.Lancet. 2006;367(9508):379-380. doi: 10.1016/S0140-6736(06)68117-8
8. Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view onmale infertility around the globe.Reprod Biol Endocrinol. 2015;13:37.doi: 10.1186/s12958-015-0032-1
9. World Health Organization. Recommendations. In: Vayena E, RowePJ, Griffin PD, eds. Current practices and controversies in assistedreproduction: report of a meeting on “Medical, Ethical and SocialAspects of Assisted Reproduction” held at WHO Headquarters inGeneva, Switzerland. World Health Organization: 2002:381-396.
10. Krausz C, Riera-Escamilla A. Genetics of male infertility.Nat Rev Urol.2018;15(6):369-384. doi: 10.1038/s41585-018-0003-3
11. Liao C, Walters BW, DiStasio M, Lesch BJ. Human-specific epigenomic states in spermatogenesis.Comput Struct Biotechnol J. 2023;23:577-588.doi: 10.1016/j.csbj.2023.12.037
12. Houston BJ, Riera-Escamilla A, Wyrwoll MJ, et al. A systematic reviewof the validated monogenic causes of human male infertility: 2020update and a discussion of emerging gene-disease relationships.HumReprod Update. 2021;28(1):15-29. doi: 10.1093/humupd/dmab030
13. Sofikitis N, Giotitsas N, Tsounapi P, Baltogiannis D, GiannakisD, Pardalidis N. Hormonal regulation of spermatogenesis andspermiogenesis.J Steroid Biochem Mol Biol. 2008;109(3-5):323-330. doi:10.1016/j.jsbmb.2008.03.004
14. Fink J, Ide H, Horie S. Management of male fertility in hypogonadalpatients on testosterone replacement therapy.Medicina. 2024;60(2):275.doi: 10.3390/medicina60020275
15. Schlegel PN. Causes of azoospermia and their management.ReprodFertil Dev. 2004;16(5):561-572. doi: 10.10371/RD03087
16. Esteves SC, Miyaoka R, Agarwal A. Surgical treatment of male infertilityin the era of intracytoplasmic sperm injection - new insights.Clinics.2011;66(8):1463-1478. doi: 10.1590/s1807-59322011000800026
17. Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette smoking andsemen quality: a new meta-analysis examining the effect of the 2010World Health Organization laboratory methods for the examinationof human semen.Eur Urol. 2016;70(4):635-645. doi: 10.1016/j.eururo.2016.04.010
18. SCooper TG, Noonan E, von Eckardstein S, et al. World HealthOrganization reference values for human semen characteristics.HumReprod Update. 2010;16(3):231-245. doi: 10.1093/humupd/dmp048
19. Esteves SC. Novel concepts in male factor infertility: clinical andlaboratory perspectives.J Assist Reprod Genet. 2016;33(10):1319-1335.doi: 10.1007/s10815-016-0763-8
20. Nair S, Jadhav S, Lila A, et al. Spectrum of phenotype and genotypeof congenital isolated hypogonadotropic hypogonadism in AsianIndians.Clin Endocrinol. 2016;85(1):100-109. doi: 10.1111/cen.13009
21. Krausz C, Riera-Escamilla A. Genetics of male infertility.Nat Rev Urol.2018;15(6):369-384. doi: 10.1038/s41585-018-0003-3
22. Lotti F, Maggi M. Ultrasound of the male genital tract in relation tomale reproductive health.Hum Reprod Update. 2015;21(1):56-83. doi:10.1093/humupd/dmu042
23. Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factorsand reproductive health: taking control of your fertility.Reprod BiolEndocrinol. 2013;11:66. doi: 10.1186/1477-7827-11-66
24. Salas-Huetos A, Bulló M, Salas-Salvadó J. Dietary patterns, foods andnutrients in male fertility parameters and fecundability: a systematicreview of observational studies.Hum Reprod Update. 2017;23(4):371-389. doi: 10.1093/humupd/dmx006
25. Tan KA, De Gendt K, Atanassova N, et al. The role of androgensin sertoli cell proliferation and functional maturation: studies inmice with total or sertoli cell-selective ablation of the androgenreceptor.Endocrinol. 2005;146(6):2674-2683. doi: 10.1210/en.2004-1630
26. Agarwal A, Majzoub A, Esteves SC, Ko E, Ramasamy R, Zini A. Clinicalutility of sperm DNA fragmentation testing: practice recommendationsbased on clinical scenarios.Transl Androl Urol. 2016;5(6):935-950. doi:10.21037/tau.2016.10.03
27. Al Bakri A, Lo K, Grober E, Cassidy D, Cardoso JP, Jarvi K. Timefor improvement in semen parameters after varicocelectomy.J Urol.2012;187(1):227-231. doi: 10.1016/j.juro.2011.09.041
28. Schlegel PN. Testicular sperm extraction: microdissection improvessperm yield with minimal tissue excision.Hum Reprod. 1999;14(1):131-135. doi: 10.1093/humrep/14.1.131
29. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnanciesafter intracytoplasmic injection of single spermatozoon into anoocyte.Lancet. 1992;340(8810):17-18. doi: 10.1016/0140-6736(92)9242f
30. Sakkas D, Ramalingam M, Garrido N, Barratt CL. Sperm selection innatural conception: what can we learn from mother nature to improveassisted reproduction outcomes?Hum Reprod Update. 2015;21(6):711-726. doi: 10.1093/humupd/dmv042
31. Agarwal A, Baskaran S, Parekh N, et al. Male infertility.Lancet.2021;397(10271):319-333. doi: 10.1016/S0140-6736(20)32667-2
32. Schlegel PN, Sigman M, Collura B, et al. Diagnosis and treatment ofinfertility in men: AUA/ASRM guideline part I.J Urol. 2021;205(1):36-43. doi: 10.1097/JU.0000000000001521
33. Tournaye H, Krausz C, Oates RD. Novel concepts in the aetiology ofmale reproductive impairment.Lancet Diab Endocrinol. 2017;5(7):544-553. doi: 10.1016/S2213-8587(16)30040-7
Article available in :
Volume 2, Issue 2, 2024
Page : 33-36
https://doi.org/10.51271/JCOGP-0031
Article Information
Received : 26 Mar 2024
Accepted : 15 Nis 2024
Published : 29 Nis 2024
Corresponding Author :

Belgin Devranoğlu: Department of Obstetrics and Gynecology, Health Sciences University Zeynep Kamil Women and Children’s Diseases Training and Research Hospital, İstanbul, Turkiye

[email protected]
Citation : Devranoğlu B, Gürbüz T, Yurci A. Male infertility: an overview of etiology, diagnosis and management. J Controv Obstetr Gynecol Ped. 2024;2(2):34-37.

Read: 584
Cited: 0
Download : 175
_Footer