Assidi, M. (2022). Infertility in Men: Advances towards a Comprehensive and Integrative Strategy for Precision Theranostics. Cells, 11(10), 1711. https://doi.org/10.3390/cells11101711
Assidi M. Infertility in Men: Advances towards a Comprehensive and Integrative Strategy for Precision Theranostics. Cells. 2022;11(10):1711. doi:10.3390/cells11101711
Assidi, Mourad. "Infertility in Men: Advances towards a Comprehensive and Integrative Strategy for Precision Theranostics." Cells, vol. 11, no. 10, 2022, pp. 1711.
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Male Infertility Has Overlapping Genetic and Lifestyle Causes
Male infertility has many overlapping causes, a 2022 review of past studies found. The review identifies interacting genetic, environmental, lifestyle, and age-related causes, and reports that standard semen testing still lacks accuracy. Male factors play a role in up to 5 out of 10 infertile couples. The rate has climbed about 0.3 percent a year, varying a lot by region.
Study at a glance, narrative review: Male infertility has many overlapping genetic and lifestyle causes. Source: Assidi M, 2022, PMID 35626747.
Key Findings
Infertility affects 15% of couples at reproductive age worldwide, and male factors contribute to up to half of these cases, ranging from 20% to 70% across regions.
Duct obstruction, which blocks ejaculation, causes about 5% of infertile men's cases, while retrograde ejaculation accounts for about 2%.
TESE or micro-TESE sperm retrieval succeeds in up to half of men with non-obstructive azoospermia, though testosterone levels were lower six months after the procedure in the studies reviewed.
Interpretation
This narrative review, published in Cells in 2022, pulls together past studies on the genes, environment, lifestyle, and age linked to male infertility. The author's view is that surgery and assisted reproduction remain the main options today. Larger, systematic studies of how these causes interact would build on this picture.
RRM Context
Restorative reproductive medicine, or RRM, evaluates both partners from the first visit and treats the cause behind infertility instead of bypassing it. This review's own numbers show male factors play a role in about half of infertility cases. Many of the causes it lists, from genes to lifestyle to anatomy, are the kind a cause-based evaluation is built to find.
Our editorial summary of this paper, not the article's abstract.
Abstract
Male infertility is an increasing and serious medical concern, though the mechanism remains poorly understood. Impaired male reproductive function affects approximately half of infertile couples worldwide. Multiple factors related to the environment, genetics, age, and comorbidities have been associated with impaired sperm function. Present-day clinicians rely primarily on standard semen analysis to diagnose male reproductive potential and develop treatment strategies. To address sperm quality assessment bias and enhance analysis accuracy, the World Health Organization (WHO) has recommended standardized sperm testing; however, conventional diagnostic and therapeutic options for male infertility, including physical examination and semen standard analysis, remain ineffective in relieving the associated social burden. Instead, assisted reproductive techniques are becoming the primary therapeutic approach. In the post-genomic era, multiomics technologies that deeply interrogate the genome, transcriptome, proteome, and/or the epigenome, even at single-cell level, besides the breakthroughs in robotic surgery, stem cell therapy, and big data, offer promises towards solving semen quality deterioration and male factor infertility. This review highlights the complex etiology of male infertility, especially the roles of lifestyle and environmental factors, and discusses advanced technologies/methodologies used in characterizing its pathophysiology. A comprehensive combination of these innovative approaches in a global and multi-centric setting and fulfilling the suitable ethical consent could ensure optimal reproductive and developmental outcomes. These combinatorial approaches should allow for the development of diagnostic markers, molecular stratification classes, and personalized treatment strategies. Since lifestyle choices and environmental factors influence male fertility, their integration in any comprehensive approach is required for safe, proactive, cost-effective, and noninvasive precision male infertility theranostics that are affordable, accessible, and facilitate couples realizing their procreation dream.
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