Impact of GLP-1 Receptor Agonists on Male Fertility: Emerging Evidence and Future Directions.

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-09-26 DOI:10.1016/j.urology.2025.09.038

Manish Kuchakulla, Phillip J Poppas, Gal Wald, John M Masterson, Aaron A Gurayah, Hriday P Bhambhvani, James A Kashanian

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引用次数: 0

Abstract

Objective: To synthesize emerging mechanistic, preclinical, and clinical evidence evaluating the impact of GLP-1RAs on male fertility, including effects on testicular function, reproductive hormones, semen parameters, and sexual function.

Methods: A comprehensive literature search was conducted across PubMed, MEDLINE, and Embase through May 31, 2025, identifying relevant preclinical and clinical studies examining GLP-1RAs and male reproductive health.

Results: The search strategy identified 16 clinical studies meeting our inclusion criteria, and these studies were included in the summary tables for review. GLP-1 receptors are present in male reproductive tissues. Preclinical studies indicate GLP-1RAs enhance spermatogenesis, hormone profiles, and sperm function in obese/diabetic rodent models via cAMP/PKA and PI3K/Akt pathways. In vitro data show improved sperm motility and Sertoli cell metabolism with GLP-1RAs. Limited clinical studies suggest potential improvements in semen parameters and testosterone levels in obese hypogonadal men, though heterogenous results highlight the need for further research.

Conclusions: GLP-1RAs likely have a beneficial effect on male fertility, particularly in the setting of metabolic dysfunction, but clinical evidence is limited. Larger prospective studies are needed to confirm safety and efficacy.

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GLP-1受体激动剂对男性生育能力的影响：新证据和未来方向。

目的：综合评价GLP-1RAs对男性生育能力影响的新机制、临床前和临床证据，包括对睾丸功能、生殖激素、精液参数和性功能的影响。方法：到2025年5月31日，在PubMed、MEDLINE和Embase上进行全面的文献检索，确定GLP-1RAs与男性生殖健康相关的临床前和临床研究。结果：检索策略确定了16项符合我们的纳入标准的临床研究，这些研究被纳入汇总表进行审查。GLP-1受体存在于男性生殖组织中。临床前研究表明，GLP-1RAs通过cAMP/PKA和PI3K/Akt通路增强肥胖/糖尿病啮齿动物模型的精子发生、激素特征和精子功能。体外数据显示，GLP-1RAs可改善精子活力和支持细胞代谢。有限的临床研究表明，在肥胖性腺功能低下的男性中，精液参数和睾丸激素水平有可能得到改善，尽管异质性的结果表明需要进一步的研究。结论：GLP-1RAs可能对男性生育能力有有益影响，特别是在代谢功能障碍的情况下，但临床证据有限。需要更大规模的前瞻性研究来确认安全性和有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.