Current drawbacks and future perspectives in the diagnosis and treatment of male factor infertility, with a focus on FSH treatment: an expert opinion

Journal of Endocrinological Investigation, Год журнала: 2025, Номер unknown

Опубликована: Янв. 13, 2025

Infertility is defined as the inability to conceive after 1 year of unprotected intercourse, affecting approximately 15-20% couples in Western countries. It a shared problem within couple; when main issue lies with one partners, it preferable refer "male factor" or "female infertility rather than simply male female infertility. Despite factor accounting for half all couple cases, clinical approach partner not uniformly standardized across international guidelines. To provide an expert overview, we have comprehensively reviewed and critically analyzed most up-to-date literature on this sensitive topic, leading development proposal tailored assessment diagnostic-therapeutic pathway preventive strategies. The diagnostic also considers that infertile men are objectively less healthy their fertile counterparts same age ethnicity. This article discusses flow, classification infertility, definition idiopathic involvement general health, treatment recommendations, emphasizing follicle-stimulating hormone selected groups patients. We opinion current drawbacks future perspectives field, practical advice practice practitioners reproductive medicine.

Язык: Английский

---

The role of luteinizing hormone activity in spermatogenesis: from physiology to clinical practice

Reproductive Biology and Endocrinology, Год журнала: 2025, Номер 23(S1)

Опубликована: Янв. 13, 2025

Язык: Английский

---

FSH Therapy in Male Factor Infertility: Evidence and Factors Which Might Predict the Response

Life, Год журнала: 2024, Номер 14(8), С. 969 - 969

Опубликована: Июль 31, 2024

Follicle-stimulating hormone (FSH) administration is applied in the management of subjects affected by hypogonadotropic hypogonadism. Whilst this application widely recognized and established alone or combination with human chorionic gonadotropin (hCG), a similar strategy empirically advocated idiopathic male factor infertility (MFI). In setting, FSH therapy has been used to increase sperm quantity, quality, pregnancy rate when plasma concentrations are below 8 IU/L seminal tract not obstructed. literature, several studies suggested that giving patients MFI increases count motility, raising overall rate. However, efficacy seems be limited, about 10–18 men should treated achieve one pregnancy. Thus, papers suggest need move from replacement approach an overstimulating MFI. To aim, it imperative determine some pharmacologic markers efficacy. Furthermore, useful clinical practice distinguish, before starting treatment, among who might respond treatment. Indeed, previous infertile have normal levels gonadotropins treatment 50% defined as “non-responders”. For these reasons, identifying predictive action spermatogenesis response fascinating area study lead new developments aim achieving personalization infertility. From perspective, parameters (i.e., spermatid count), testicular cytology, genetic assessment, miRNA protein future create tailored plan. The mandatory minimize side effects, avoid lost time ineffective treatments, improve efficacy, predicting most efficient dose duration This narrative review’s objective discuss role different putative factors which proposed predict men.

Язык: Английский

---

Human chorionic gonadotropin‐based clinical treatments for infertile men with non‐obstructive azoospermia

Andrology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 4, 2025

Abstract Spermatogenesis is primarily controlled by follicle‐stimulating hormone and luteinizing hormone‐driven testosterone. Luteinizing acts on the Leydig cells, stimulating steroid production, predominantly testosterone, activating critical inter‐related spermatogenesis regulatory pathways. Despite evidence that exogenous gonadotropins containing activity, particularly human chorionic gonadotropin, can effectively restore in azoospermic males with hypogonadotropic hypogonadism, use of these drugs to treat other forms non‐obstructive azoospermia subject an ongoing debate. In this review, we delve into molecular properties functions gonadotropin regulation explore available preparations for therapeutic use. We examine regarding effectiveness treating infertility men pre‐testicular or testicular and, additionally, identify main areas future research. Our review highlights role activity emphasizes potential male infertility. The variation characteristics patients underscores importance assessing hormonal profiles when contemplating treatment patients. A novel stratification patients, APHRODITE criteria, which considers clinical laboratory indicators, may assist identifying individuals who could benefit from therapy. While accumulating suggests promising venues pharmacological infertility, including azoospermia, further research required completely elucidate mechanisms underlying effects sperm production establish most effective dosages durations.

Язык: Английский

---

Clinical factors impacting microdissection testicular sperm extraction success in hypogonadal men with nonobstructive azoospermia

Fertility and Sterility, Год журнала: 2024, Номер 122(4), С. 636 - 647

Опубликована: Июнь 22, 2024

To explore factors influencing microdissection testicular sperm extraction (micro-TESE) success in hypogonadal men with nonobstructive azoospermia (NOA).

Язык: Английский

---

Non-Obstructive Azoospermia and Intracytoplasmic Sperm Injection: Unveiling the Chances of Success and Possible Consequences for Offspring

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(16), С. 4939 - 4939

Опубликована: Авг. 21, 2024

Non-obstructive azoospermia (NOA) is found in up to 15% of infertile men. While several causes for NOA have been identified, the exact etiology remains unknown many patients. Advances assisted reproductive technology, including intracytoplasmic sperm injection (ICSI) and testicular retrieval, provided hope these This review summarizes chances success with ICSI patients examines preoperative factors laboratory techniques associated positive outcomes. Furthermore, we reviewed possible consequences offspring by use retrieved from interventions that could potentially mitigate risks. Testicular may exhibit increased chromosomal abnormalities, although lower fertilization pregnancy rates are reported compared other forms infertility, available evidence does not suggest a significant increase miscarriage rate, congenital malformation, or developmental delay their less severe infertility fertile However, due limited data, should receive specialized care personalized management. Counseling essential before initiating any fertility enhancement treatment only health risks but also enhance successful outcomes minimize offspring.

Язык: Английский

---

Are they functional hypogonadal men? Testosterone serum levels unravel male idiopathic infertility subgroups

Endocrine, Год журнала: 2024, Номер 84(2), С. 757 - 767

Опубликована: Фев. 19, 2024

To evaluate total testosterone distribution in male idiopathic infertility.

Язык: Английский

---

Approaching treatment of male infertility: the APHRODITE criteria

International braz j urol, Год журнала: 2024, Номер 50(3), С. 359 - 365

Опубликована: Май 27, 2024

Язык: Английский

---

Ibuprofen use and male infertility: Insights from a nationwide retrospective cohort study

European Journal of Obstetrics & Gynecology and Reproductive Biology, Год журнала: 2025, Номер 307, С. 128 - 133

Опубликована: Фев. 2, 2025

Язык: Английский

---

A core outcome set for future male infertility research: development of an international consensus

Human Reproduction, Год журнала: 2025, Номер unknown

Опубликована: Апрель 16, 2025

Abstract STUDY QUESTION Can a core outcome set be developed through global consensus to standardize selection, collection, comparison, and reporting in future male infertility trials? SUMMARY ANSWER A minimum dataset, known as ‘core set’, has been for randomized controlled trials (RCTs) systematic reviews evaluating potential interventions infertility. WHAT IS KNOWN ALREADY Numerous factors, including failure consider the perspectives of men with lived experiences or their partners when developing conducting RCTs can limit clinical utility. Selection outcomes, variations definitions, selective outcomes based on statistical analysis make results research challenging interpret, compare, implement. For infertility, this is further compounded by there being potentially three participants, male, female partner, any offspring born, all reported. This led significant heterogeneity trial design reporting. While general developed, no such trials. DESIGN, SIZE, DURATION two-round Delphi survey (334 participants from 39 countries) development workshops (44 21 countries). PARTICIPANTS/MATERIALS, SETTING, METHODS Healthcare professionals, researchers, women were brought together transparent process using formal science methods. MAIN RESULTS AND THE ROLE OF CHANCE The inclusion specific male-factor addition set. These include assessment semen World Health Organization recommendations analysis; viable intrauterine pregnancy confirmed ultrasound (accounting singleton, twin, higher multiple pregnancies); loss ectopic pregnancy, miscarriage, stillbirth, termination pregnancy); live birth; gestational age at delivery; birthweight; neonatal mortality; major congenital anomaly. Although not requirement part set, other identified useful certain study settings. LIMITATIONS, REASONS FOR CAUTION We used methods work, which have inherent limitations, representativeness participant sample, attrition, an arbitrary threshold. WIDER IMPLICATIONS FINDINGS Embedding within should ensure comprehensive are inconsistently reported present. Research funding bodies, Standard Protocol Items: Recommendations Interventional Trials (SPIRIT) statement, over 80 specialty journals, Cochrane Gynaecology Fertility Group, Sterility Human Reproduction, committed implementing FUNDING/COMPETING INTEREST(S) work was funded Urology Foundation, Small Project Fund awarded Michael P Rimmer University Edinburgh, UK. RTM supported United Kingdom Innovation (UKRI) Future Leaders Fellowship (MR/Y011783/1). C.L.R.B. co-editor chief Reproduction recipient BMGF grant received consultancy fees Exscentia Exceed sperm testing, paid Dundee speaking honoraria personally Ferring, Copper Surgical RBMO. R.P.B. receives royalties Flow diagnósticos. M.L.E. advisor companies Hannah, Illumicell, Next, Legacy, Doveras, Vseat fee this. B.W.M. consultant Norgine Organon Ferring Merck, he also travel support Merck. R.R.H. Elsevier book, Glyciome, presentation GryNumber Aytu Bioscience. Attendance 2020 Roadshow South Africa Ralf Henkel LogixX Pharma Ltd. Editor Chief Andrologia employee since 2020. M.S.K. associate editor Open. K.Mc.E. attend 2025 British Society Chair Society. He member HFEA’s Scientific Clinical Advances Advisory Committee Member NICE Problems Guideline Group. M.H.V.L. consultation WHO Manual Spanish translation, expenses ESHRE MRHI meeting Budapest. She editorial board & Sterility, F&S Science, Frontiers Endocrinology. panel (WHO) Programme (HRP) Review Panel. R.S.M. former chair A. Perheentupa lecturing Merck Tackling Infertility manifest, Gedeon Richter Ferring. declares lecture Gideon Richter, Ferring; payment manifesto. Pacey Carrot Cryos International well IBSA Institut Biochimique SA Mealis Group—all Manchester. Trustee Progress Educational. Trust (Charity Number 1139856) Chairman UKNEQAS Reproductive Sciences Committee. F.T. Bayer grant, DFG Unit ‘Male Germ Cells’ (CRU326, project number 329621271) BMBF Junior Scientist Centre ‘ReproTrack.MS’ (grant 01GR2303), Organon. M.v.W. Editor-in-Chief Update. R.W. Deputy currently TRIAL REGISTRATION NUMBER Core Outcome Measures Effectiveness (COMET) initiative registration No: 1586. Available www.comet-initiative.org/Studies/Details/1586.

Язык: Английский

---