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Frequency, morbidity and equity — the case for increased research on male fertility

Lookup NU author(s): Dr Brendan Houston, Professor Joris VeltmanORCiD


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© 2023, Springer Nature Limited. Currently, most men with infertility cannot be given an aetiology, which reflects a lack of knowledge around gamete production and how it is affected by genetics and the environment. A failure to recognize the burden of male infertility and its potential as a biomarker for systemic illness exists. The absence of such knowledge results in patients generally being treated as a uniform group, for whom the strategy is to bypass the causality using medically assisted reproduction (MAR) techniques. In doing so, opportunities to prevent co-morbidity are missed and the burden of MAR is shifted to the woman. To advance understanding of men’s reproductive health, longitudinal and multi-national centres for data and sample collection are essential. Such programmes must enable an integrated view of the consequences of genetics, epigenetics and environmental factors on fertility and offspring health. Definition and possible amelioration of the consequences of MAR for conceived children are needed. Inherent in this statement is the necessity to promote fertility restoration and/or use the least invasive MAR strategy available. To achieve this aim, protocols must be rigorously tested and the move towards personalized medicine encouraged. Equally, education of the public, governments and clinicians on the frequency and consequences of infertility is needed. Health options, including male contraceptives, must be expanded, and the opportunities encompassed in such investment understood. The pressing questions related to male reproductive health, spanning the spectrum of andrology are identified in the Expert Recommendation.

Publication metadata

Author(s): Kimmins S, Anderson RA, Barratt CLR, Behre HM, Catford SR, De Jonge CJ, Delbes G, Eisenberg ML, Garrido N, Houston BJ, Jorgensen N, Krausz C, Lismer A, McLachlan RI, Minhas S, Moss T, Pacey A, Priskorn L, Schlatt S, Trasler J, Trasande L, Tuttelmann F, Vazquez-Levin MH, Veltman JA, Zhang F, O'Bryan MK

Publication type: Article

Publication status: Published

Journal: Nature Reviews Urology

Year: 2024

Volume: 21

Pages: 102–124

Print publication date: 01/02/2024

Online publication date: 12/10/2023

Acceptance date: 31/08/2023

ISSN (print): 1759-4812

ISSN (electronic): 1759-4820

Publisher: Springer Nature


DOI: 10.1038/s41585-023-00820-4

PubMed id: 37828407


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Funder referenceFunder name
Canada Research Chairs program
Canadian Institutes of Health Research
National Health and Medical Research Council of Australia