Grande, G., & Foresta, C. (2023). Male Reproduction: From Pathophysiology to Clinical Assessment. Springer book chapter (Practical Clinical Andrology). https://doi.org/10.1007/978-3-031-11701-5_12
Grande G, Foresta C. Male Reproduction: From Pathophysiology to Clinical Assessment. Springer book chapter (Practical Clinical Andrology). 2023. doi:10.1007/978-3-031-11701-5_12
Grande, Giuseppe, and Carlo Foresta. "Male Reproduction: From Pathophysiology to Clinical Assessment." Springer book chapter (Practical Clinical Andrology), 2023.
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PFAS, HPV and obesity are linked to lower male fertility
A review links PFAS chemicals, HPV and obesity to poorer sperm health in men. The chapter, from an Italian andrology group, gathers lab, animal and human studies. Between 30% and 60% of infertile men get no clear diagnosis. The authors suggest these exposures may play a role in many of those cases.
Key Findings
Infertility affects one out of six couples in Western countries. Male factor infertility is implicated in about 50% of cases.
Among infertile men, 30–60% are left without a clear diagnosis.
The authors compared 212 young men from a PFAS-contaminated area of northeast Italy with 171 age-matched controls. Most exposed men had reduced testicular volume, penile length and anogenital distance.
In HPV-infected men, viral clearance of approximately 85.3% was reached after 24 months of follow-up. Fewer anti-sperm antibodies and better sperm motility paralleled the clearance.
Obese men had continuously raised scrotal temperature with less day-to-night variation. Healthy controls showed a pattern that swung between day and night.
Interpretation
This chapter in a clinical andrology textbook reviews lab, animal and human evidence on PFAS, HPV and obesity in male infertility. Many human findings are associations. Mechanisms come from cell and animal experiments. One example: sperm exposed to PFOA in a dish. The authors note that PFAS research has focused mostly on female fertility. The findings support further study of these exposures in male infertility care.
RRM Context
Restorative reproductive medicine treats unexplained infertility as undiagnosed. The 30–60% of infertile men with no clear diagnosis fits that view. The three exposures give clinicians specific causes to look for in the male partner. The chapter puts male factor at about 50% of cases, which supports evaluating both partners from the start.
Our editorial summary of this paper, not the article's abstract.
Abstract
Male infertility may depend by pre-testicular (for example, hypothalamic or pituitary diseases), testicular, and post-testicular (for example, obstructive pathologies of seminal ducts) causes. However, a large proportion (30–60%) of infertile males does not receive a clear diagnosis. In these cases, generally reported as idiopathic infertility, there is a strong suspicion of genetic factors yet to be discovered. Furthermore, male fertility may be influenced by a host of lifestyle risk factors such as environment, nutrition, exposure to infections, and smoking. Therefore, lifestyle and environment risk factors may have a role in many cases of idiopathic male infertility. In this chapter, we focus our attention on these risk factors, discussing three paradigmatic situations of interference between environment/lifestyle and male fertility, thus providing the pathophysiological basis of their detrimental impact on male fertility: exposure to environmental endocrine disruptors, such as perfluoro-alkyl substances (PFAS); exposure to viruses, such as HPV; effect of nutritional status and obesity.
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