Male Infertility and Reproductive Health

Male infertility encompasses a spectrum of disorders affecting spermatogenesis, sperm function and reproductive hormones that contribute to couple infertility. Epidemiological data indicate a global decline in sperm concentrations over recent decades, reflecting the complex interplay of genetic mutations, endocrine disruption, environmental exposures and lifestyle factors. Etiologies range from chromosomal aberrations and monogenic defects to testicular injury, varicocele, metabolic disease and oxidative stress. Beyond its direct impact on reproductive outcomes, poor semen quality often signals broader health challenges, including metabolic syndrome, cardiovascular disease and increased cancer risk. Contemporary research seeks to unravel the molecular mechanisms of germ cell development, to refine diagnostic classifications and to develop personalised interventions, from lifestyle optimisation to advanced assisted reproductive technologies. Together, these efforts aim to improve fertility outcomes while shedding light on male reproductive health as an integral component of overall well-being.

Research from Nature Portfolio

Recent studies have illuminated the mechanistic link between systemic vascular health and spermatogenesis. Animal models of hypertension have revealed that elevated blood pressure induces testicular microvascular dysfunction, impairing vasomotion, disrupting seminiferous tubule architecture and reducing sperm concentration, motility and DNA integrity. These findings identify testicular microcirculation as a novel target in the prevention of infertility among men with cardiovascular disease. In parallel, population-based analyses have observed that men undergoing intracytoplasmic sperm injection exhibit higher rates of prescriptions for antihypertensive and metabolic syndrome medications compared with naturally conceiving fathers. This association underscores the convergence of subfertility and cardiometabolic risk, supporting the utility of fertility clinics as points of intervention for men’s health beyond reproduction.

Male Infertility and Reproductive Health publication trend

The graph below shows the total number of articles in male infertility and reproductive health across all publications each year (not limited to Nature Index journals).

Technical terms

Azoospermia: Absence of sperm in the ejaculate.

Oligozoospermia: Reduced sperm concentration in the ejaculate.

Intracytoplasmic sperm injection (ICSI): Assisted reproductive technique where a single sperm is injected directly into an oocyte.

Sperm DNA fragmentation (SDF): Measure of genetic strand breaks within sperm nuclei, indicative of DNA damage.

Metabolic syndrome: Cluster of metabolic risk factors including hypertension, dyslipidaemia and insulin resistance that predispose to cardiovascular disease.

References

1. Current global status of male reproductive health. Human Reproduction Open (2024).
2. Systemic arterial hypertension leads to decreased semen quality and alterations in the testicular microcirculation in rats. Scientific Reports (2019).
3. More Prevalent Prescription of Medicine for Hypertension and Metabolic Syndrome in Males from Couples Undergoing Intracytoplasmic Sperm Injection. Scientific Reports (2018).
4. Diabetes and male fertility disorders. Molecular Aspects of Medicine (2024).
5. A global approach to addressing the policy, research and social challenges of male reproductive health. Human Reproduction Open (2021).
6. Triglycerides/Glucose Index Is Associated with Sperm Parameters and Sperm DNA Fragmentation in Primary Infertile Men: A Cross-Sectional Study. Metabolites (2022).