Infertility is a prevalent issue affecting many couples during their reproductive years, with a significant number facing challenges in conceiving despite regular unprotected intercourse. Male factor infertility (MFI) contributes significantly to these cases, with a significant proportion of men lacking an identifiable etiology. As such, a thorough assessment of MFI has become increasingly vital for personalized management. This position paper from the Andrology team at IRCCS Ospedale San Raffaele emphasizes a comprehensive and individualized approach to MFI work-up, addressing the evolving challenges encountered in clinical practice. Our approach involves a thorough diagnostic work-up to identify the underlying causes of MFI, integrating insights from extensive literature review and our proprietary data. Our data demonstrates that an extensive diagnostic assessment allows us to identify at least one underlying cause of MFI in most infertile men. However, challenges persist in diagnosing less severe phenotypes with unclear etiology. We discuss the importance of individualized MFI work-up and its implications for developing rational therapeutic protocols. Lastly, this paper highlights the necessity for a personalized diagnostic assessment, addressing the daily clinical challenges and emphasizing tailored approaches to try to improve outcomes among couples seeking first medical help for infertility.
The world journal of men's health. 2024 Jun 19 [Epub ahead of print]
Edoardo Pozzi, Federico Belladelli, Christian Corsini, Luca Boeri, Paolo Capogrosso, Giuseppe Fallara, Luigi Candela, Alessandro Bertini, Francesco Cattafi, Massimiliano Raffo, Walter Cazzaniga, Eugenio Ventimiglia, Alessia d'Arma, Massimo Alfano, Rayan Matloob, Enrico Papaleo, Massimo Candiani, Francesco Montorsi, Andrea Salonia
University Vita-Salute San Raffaele, Milan, Italy., Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Department of Urology, Circolo & Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy., Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy., Department of Urology, The Royal Marsden NHS Foundation Trust, London, UK., Department of Obstetrics and Gynaecology, IRCCS Ospedale San Raffaele, Milan, Italy.