In a recent study published within the journal Nature Reviews Urology, researchers addressed probably the most pertinent questions concerning male infertility. They discussed the present understanding of the topic, in addition to the areas and opportunities for improving male reproductive health.

Expert Advice: Frequency, morbidity and equity — the case for increased research on male fertility. Image Credit: Vadi Fuoco / Shutterstock

Background

Although the incidence of infertility amongst middle-aged men and girls is sort of equal, the dearth of understanding about points related to male gamete production and the impact of lifestyle and environmental aspects has resulted in a scarcity of clarity in regards to the etiology of male infertility. The health system also fails to grasp the importance of male infertility as a biomarker for other systemic illnesses or the advantages of improved knowledge of male reproductive health in medically assisted reproduction (MAR) technology.

The tests to exactly diagnose male infertility are still rare, and infertility is principally diagnosed using family histories, semen analyses, physical examinations, and surrogate markers in the shape of hormone profiles. Moreover, the categories used to group men who seek MAR are broad, comparable to azoospermia, asthenozoospermia, oligozoospermia, and teratozoospermia, which may have multiple underlying causes. The shortage of clarity about male infertility makes it difficult to treat the condition and sometimes leads to the feminine partner being misassigned the burden of treatment in cases of infertile couples looking for MAR.

Concerning the study

In the current study, the researchers emphasize the necessity for a greater understanding of the underlying causes of male infertility, comparable to an interplay of epigenetic and genetic aspects and the influence of lifestyle selections and environmental aspects. Moreover, they consider that the problem of male infertility extends beyond the conception of offspring and in addition impacts other points of health, with studies indicating that the disease burden is higher amongst infertile men than fertile men. The necessity to raised understand male infertility is imperative also from the attitude of ensuring that children conceived through MAR don’t inherit the genetic aspects that cause male infertility.

The current review was a results of a request from the Male Reproductive Health Initiative (MRHI), which is an element of the European Society of Human Reproduction and Embryology, for a suggestion document that might provide clarity on the present knowledge about male reproductive health and medicine, and discover research gap areas for further improvement. This document is meant for researchers in the sector, in addition to the governments and general public. The recommendations address a number of the most pertinent questions related to male infertility and are a results of consultations with experts in the sector of andrology research, public policy, and clinical practice from across the globe.

Results

The researchers identified 13 of probably the most vital questions regarding male infertility and addressed these questions with the aim of improving the understanding, diagnoses, and treatment options for male infertility. The primary query addresses the worldwide prevalence of male infertility, and surprisingly, there’s a scarcity of clarity on the topic. An accurate estimation of the prevalence of male infertility has proven difficult because most of the knowledge comes from data from infertility clinics or from studies examining populations which can be in danger, comparable to those exposed to specific toxins.

Moreover, assessments of male infertility are based on semen evaluation from heterosexual couples looking for MAR. The prognostic ability of semen evaluation shouldn’t be accurate, and the flexibility to conceive is predicated on the combined fertility of the couple. Subsequently, in lots of cases, men with impaired spermatogenesis and reduced fertility still manage to conceive if their female partner is healthy, and cases often come to light provided that the feminine partner also suffers from reduced fertility.

With regard to diagnostic techniques, the review discussed the mixture of methods currently used to diagnose male infertility but highlighted the dearth of clarity in determining the causality of the cellular or physiological deficits identified through these tests.

The opposite areas of concern discussed within the review included the present treatment options that exist for addressing male infertility and the necessity for improved options. The review also discussed the genetic aspects, in addition to the approach to life selections and environmental aspects that impact male fertility. Epigenetic aspects and their influence on male fertility and the inter-generational consequences of those epigenetic aspects were also discussed.

A number of the other points of male reproductive health addressed on this review were the economic burden, in addition to the disease burden, of male infertility and the opportunity of developing gamete storage or restoration protocols before the administration of medical interventions.

The study also addressed the long-term impact of compromised fertility on the health of youngsters conceived naturally or through assisted reproduction to men with impaired fertility. Lastly, the researchers addressed the necessity for improved communication about andrology and male infertility with health professionals, policymakers, funding agencies, and most people.

Conclusions

Overall, this comprehensive review on male reproductive health addressed the numerous areas of research, including a greater understanding of the prevalence of male infertility and improved diagnosis and treatment methods. The researchers also discussed the necessity to grasp the underlying causes of male infertility and to enhance the communication of knowledge about andrology to varied stakeholders and most people.