The Andrological Landscape in the Twenty-First Century: Making Sense of the Advances in Male Infertility Management for the Busy Clinicians

Ahmad Motawi, Andrea Crafa, Taha Hamoda, Rupin Shah and Ashok Agarwal ()
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Ahmad Motawi: Department of Andrology, Sexual Medicine and STIs, Faculty of Medicine, Cairo University, Cairo 11956, Egypt
Andrea Crafa: Global Andrology Forum (GAF), Moreland Hills, OH 44022, USA
Taha Hamoda: Global Andrology Forum (GAF), Moreland Hills, OH 44022, USA
Rupin Shah: Global Andrology Forum (GAF), Moreland Hills, OH 44022, USA
Ashok Agarwal: Global Andrology Forum (GAF), Moreland Hills, OH 44022, USA

IJERPH, 2024, vol. 21, issue 9, 1-18

Abstract: Male infertility represents a significant global problem due to its essential health, social, and economic implications. It is unsurprising that scientific research is very active in this area and that advances in the diagnostic and therapeutic fields are notable. This review presents the main diagnostic advances in male infertility, starting from the changes made in the latest WHO Manual of semen analysis and discussing the more molecular aspects inherent to “omics”. Furthermore, the usefulness of artificial intelligence in male infertility diagnostics and the latest advances in varicocele diagnosis will be discussed. In particular, the diagnostic path of male infertility is increasingly moving towards a personalized approach to the search for the specific biomarkers of infertility and the prediction of treatment response. The treatment of male infertility remains empirical in many regards, but despite that, advances have been made to help formulate evidence-based recommendations. Varicocele, the most common correctable cause of male infertility, has been explored for expanded indications for repair. The following expanded indications were discussed: elevated sperm DNA fragmentation, hypogonadism, orchalgia, and the role of varicocele repair in non-obstructive azoospermia. Moving forward with the available data, we discussed the stepwise approach to surgical sperm retrieval techniques and the current measures that have been investigated for optimizing such patients before testicular sperm extraction. Finally, the key points and expert recommendations regarding the best practice for diagnosing and treating men with infertility were summarized to conclude this review.

Keywords: male infertility; diagnosis of male infertility; treatment of male infertility; varicocele; sperm DNA fragmentation; WHO Manual; omics; artificial intelligence; home semen analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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