World J Mens Health.
2023 Apr;41(2):237-254. 10.5534/wjmh.220213.
The Renaissance of Male Infertility Management in the Golden Age of Andrology
- Calogero AE1
- Cannarella R1,2
- Agarwal A
3,4 - Abdel-Meguid Hamoda TAA5,6
- Rambhatla A7
- Saleh R8,9
- Boitrelle F10,11
- Ziouziou I12
- Toprak T13
- Gul M14
- Avidor-Reiss T15,16
- Kavoussi P17
- Chung E18
- Birowo P19
- Ghayda RA20
- Ko E21
- Colpi G22
- Dimitriadis F23
- Russo GI24
- Martinez M25
- Calik G26
- Kandil H27
- Salvio G28
- Mostafa T29
- Lin H30
- Park HJ31,32
- Gherabi N33
- Vinh Phuoc NH34
- Quang N35,36
- Adriansjah R37
- Vignera SL1
- Micic S38
- Durairajanayagam D39
- Serefoglu EC40
- Karthikeyan VS41
- Kothari P42
- Atmoko W43
- Shah R44
- Affiliations
-
- 1Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- 2Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
- 3Global Andrology Forum, Moreland Hills, OH, USA
- 4Cleveland Clinic Foundation, Cleveland, OH, USA
- 5Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
- 6Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
- 7Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
- 8Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
- 9Ajyal IVF Center, Ajyal Hospital, Sohag, Egypt
- 10Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- 11Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- 12Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
- 13Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- 14Department of Urology, Selcuk University School of Medicine, Konya, Turkey
- 15Department of Biological Sciences, University of Toledo, Toledo, OH, USA
- 16Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
- 17Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
- 18Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
- 19Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- 20Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
- 21Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
- 22Next Fertility Procrea, Lugano, Switzerland
- 23Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- 24Urology Section, University of Catania, Catania, Italy
- 25Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
- 26Department of Urology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
- 27Fakih IVF Fertility Center, Abu Dhabi, UAE
- 28Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
- 29Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
- 30Department of Urology, Peking University Third Hospital, Peking University, Beijing, China
- 31Department of Urology, Pusan National University School of Medicine, Busan, Korea
- 32Medical Research Institute of Pusan National University Hospital, Busan, Korea
- 33Faculty of Medicine, Algiers University, Algiers, Algeria
- 34Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- 35Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- 36Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
- 37Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Banding, Indonesia
- 38Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
- 39Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
- 40Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
- 41Andrology Unit, Department of Urology, Apollo Hospitals, Greams Road, Chennai, India
- 42Department of Urology, B.Y.L Nair Ch Hospital, Mumbai, India
- 43Department Department of Urology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- 44Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- KMID: 2540960
- DOI: http://doi.org/10.5534/wjmh.220213
Abstract
- Infertility affects nearly 186 million people worldwide and the male partner is the cause in about half of the cases. Meta-regression data indicate an unexplained decline in sperm concentration and total sperm count over the last four decades, with an increasing prevalence of male infertility. This suggests an urgent need to implement further basic and clinical research in Andrology. Andrology developed as a branch of urology, gynecology, endocrinology, and, dermatology. The first scientific journal devoted to andrological sciences was founded in 1969. Since then, despite great advancements, andrology has encountered several obstacles in its growth. In fact, for cultural reasons, the male partner has often been neglected in the diagnostic and therapeutic workup of the infertile couple. Furthermore, the development of assisted reproductive techniques (ART) has driven a strong impression that this biotechnology can overcome all forms of infertility, with a common belief that having a spermatozoon from a male partner (a sort of sperm donor) is all that is needed to achieve pregnancy. However, clinical practice has shown that the quality of the male gamete is important for a successful ART outcome. Furthermore, the safety of ART has been questioned because of the high prevalence of comorbidities in the offspring of ART conceptions compared to spontaneous conceptions. These issues have paved the way for more research and a greater understanding of the mechanisms of spermatogenesis and male infertility. Consequently, numerous discoveries have been made in the field of andrology, ranging from genetics to several “omics” technologies, oxidative stress and sperm DNA fragmentation, the sixth edition of the WHO manual, artificial intelligence, management of azoospermia, fertility in cancers survivors, artificial testis, 3D printing, gene engineering, stem cells therapy for spermatogenesis, and reconstructive microsurgery and seminal microbiome. Nevertheless, as many cases of male infertility remain idiopathic, further studies are required to improve the clinical management of infertile males. A multidisciplinary strategy involving both clinicians and scientists in basic, translational, and clinical research is the core principle that will allow andrology to overcome its limits and reach further goals. This state-of-the-art article aims to present a historical review of andrology, and, particularly, male infertility, from its “Middle Ages” to its “Renaissance”, a golden age of andrology.
