Andrology最新文献

{"title":"Emerging Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Male Sexual Hormones and Behaviors: Systematic Review and Meta-Analysis","authors":"Giovanni Corona,&nbsp;Clotilde Sparano,&nbsp;Marilina Romeo,&nbsp;Giulia Rastrelli,&nbsp;Linda Vignozzi,&nbsp;Mario Maggi","doi":"10.1111/andr.70238","DOIUrl":"10.1111/andr.70238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) in weight loss and long-term cardiovascular (CV) safety is established. The role of these medications on male sexual hormones and function has not been adequately clarified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To systematically review and meta-analyze the effects of GLP1-RA and SGLT2i on obesity-associated hypogonadism and sexual dysfunctions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of Medline was conducted from 1969 to August 2025, according to PRISMA and MOOSE guidelines. All observational or randomized controlled trials evaluating the effects of GLP1-RA or SGLT2i on hormonal and/or sexual parameters in overweight and obese subjects with or without diabetes mellitus (DM) were included in the analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies, including 375 subjects, evaluated the effects of GLP1-RAs, whereas three, accounting for 52 subjects, investigated the effects of SGLT2is. Both classes of medications showed an overall improvement of body composition and metabolic profile, resulting in positive erectile function outcomes. Only GLP1-RAs significantly increased total and calculated free testosterone along with gonadotropins. The findings of GLP1-RAs on T levels were independent from the observed weight loss, suggesting a direct, rather than an indirect, mechanism of action on the hypothalamus–pituitary–testis axis. Finally, the use of testosterone replacement therapy (TRT) showed better results as compared to GLP1-RAs when orgasm and sexual satisfaction domains were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Present data support the use of GLP1-RAs for improving sexual dysfunction, and its underlying CV problems, in obese patients with ED. A combination of TRT and GLP1-RAs can be considered in selected cases. Data on SGLT2is are too limited to draw final conclusions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":"14 7","pages":"1988-2001"},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/andr.70238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trimethylamine N-oxide, a Gut Microbiota Metabolite, Promotes Diabetes-Mediated Erectile Dysfunction via a PANoptotic-Like Process Involving Pyroptosis, Apoptosis, and Necroptosis in CCSMCs.","authors":"Zhan-Sen Huang, Ying Chen, Zi-Jun Du, Hao Li, Jia-Xin Feng, Bo-Wen Tang, Su-Shun Yuan, Hong-Chen Luan, Wei-He Quan, Jin-Ming Di, Jun Chen","doi":"10.1111/andr.70385","DOIUrl":"https://doi.org/10.1111/andr.70385","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Trimethylamine N-oxide (TMAO), a key metabolite derived from gut microbiota dysbiosis, is known to influence various diabetic vascular complications. However, its specific role and the programmed cell death mechanisms underlying the development of diabetes-mediated erectile dysfunction (DMED) remain to be fully elucidated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the mechanism by which TMAO mediates corpus cavernosum smooth muscle cell (CCSMC) dysfunction and promotes DMED in type 1 diabetic rats, with a focus on the involvement of the PI3K/Akt-regulated PANoptotic-like process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A type 1 diabetes-mediated erectile dysfunction (T1DMED) rat model was established. Fecal samples were collected for gut microbiota analysis, and serum TMAO levels were measured. Primary CCSMCs were isolated, and cell purity was confirmed via immunofluorescence and flow cytometry. An in vitro TMAO-induced CCSMC injury model was constructed, followed by transcriptome sequencing to identify differentially expressed genes (DEGs) and enriched KEGG signaling pathways. Western blotting and immunohistochemistry (IHC) were performed to detect markers of a PANoptotic-like process (encompassing pyroptosis, apoptosis, and necroptosis) and pathway proteins in penile tissues. Human single-cell RNA sequencing (scRNA-seq) data from penile cavernous tissues were analyzed to compare the PI3K/Akt axis and the PANoptotic-like process-related genes in CCSMCs between DMED patients and healthy controls. TMAO-injured CCSMCs were treated with the ROS scavenger N-acetylcysteine (NAC) and the PI3K/Akt inhibitor LY294002. Flow cytometry and Western blotting were used to quantify markers of this death program and pathway activity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;T1DMED rats exhibited reduced gut microbiota diversity, with Dorea as the dominant genus. Serum TMAO levels were significantly elevated in the ED group compared with the normal and diabetic non-ED groups. Parabacteroides was positively correlated with TMAO levels, whereas Oscillospira showed a negative correlation. Transcriptome sequencing of TMAO-treated CCSMCs revealed significant enrichment of the PI3K/Akt signaling pathway. IHC and Western blotting confirmed the marked activation of the PANoptotic-like process in penile tissues of T1DMED rats. Analysis of human scRNA-seq data revealed significant upregulation of PI3K/Akt signaling and genes associated with the PANoptotic-like program (e.g., CASP1, CASP3, CASP8, and MLKL) in CCSMCs from DMED patients. Flow cytometry demonstrated increased Caspase-1 and Caspase-3 positivity in TMAO-treated CCSMCs. NAC significantly reduced both readouts, whereas LY294002 significantly reduced Caspase-3 positivity but not Caspase-1 positivity. Western blotting confirmed that PI3K and PANoptotic-like markers were upregulated in TMAO-treated CCSMCs, while α-SMA and eNOS were downregulated. NAC treatment attenuated the TMAO-induced oxidati","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissection of Obesity-Induced Spermatogenic Dysfunction at Single-Cell Resolution.","authors":"Xiqiao Xu, Yining Xu, Keer Wang, Qingling Yang, Yingpu Sun","doi":"10.1111/andr.70378","DOIUrl":"https://doi.org/10.1111/andr.70378","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major risk factor for male infertility; however, how different obesity etiologies reshape testicular cellular states and transcriptional programs remains poorly understood.</p><p><strong>Objectives: </strong>This study aimed to characterize cell-type-specific transcriptional alterations associated with testicular dysfunction in dietary and genetic obesity models using single-cell RNA sequencing.</p><p><strong>Methods: </strong>Normal diet (ND) mice served as controls, whereas high-fat diet (HFD) and leptin-deficient obese (OB) mice represented diet-induced and genetic obesity models, respectively. Testicular phenotypes were evaluated, and single-cell RNA sequencing was performed to characterize obesity-associated changes in cellular composition, developmental trajectories, transcriptional programs, inferred metabolic activity, and regulatory networks.</p><p><strong>Results: </strong>Both HFD and OB mice exhibited impaired reproductive phenotypes, accompanied by alterations in testicular cellular composition. Single-cell analysis revealed increased proportions of early germ-cell populations and reduced mature spermatid populations in obese testes. Spermatocytes showed the most prominent transcriptional alterations, characterized by disrupted developmental trajectories, enhanced stress- and metabolism-associated programs, and altered expression of genes involved in meiotic progression and DNA damage responses. Increased RAD51 accumulation further indicated activation of meiotic DNA damage response pathways in obese testes. In addition, somatic populations, including Leydig cells, Sertoli cells, and immune cells, exhibited altered metabolic and endocrine-related transcriptional programs. Although both obesity models shared common transcriptional changes, OB mice displayed broader alterations involving mitochondrial, steroidogenic, and developmental programs.</p><p><strong>Discussion: </strong>These findings reveal that obesity-associated testicular dysfunction involves coordinated alterations in germ-cell developmental programs and somatic-cell metabolic states. The distinct transcriptional responses between dietary and genetic obesity highlight how obesity etiology shapes cellular alterations within the testicular microenvironment.</p><p><strong>Conclusion: </strong>This study provides a single-cell framework for understanding how different obesity states affect testicular cellular organization and transcriptional regulation, providing insights into the cellular and transcriptional basis of obesity-associated impairment of spermatogenesis.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Disorders and Male Infertility: Integrated Mechanisms and Precision Therapeutic Strategies","authors":"Jinyue Rong,&nbsp;Meng Dong","doi":"10.1111/andr.70191","DOIUrl":"10.1111/andr.70191","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Male factor infertility accounts for nearly half of infertility cases worldwide, yet modifiable lifestyle-related risk factors remain insufficiently integrated into andrological research and clinical practice. Sleep disorders have emerged as an increasingly important but underrecognized determinant of male reproductive health, with growing evidence linking disturbed sleep to impaired spermatogenesis and gonadal dysfunction.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This review synthesizes current evidence on the association between sleep disorders and male infertility, identifies key mechanistic pathways underlying sleep-related reproductive impairment, and proposes an integrated pathophysiological framework to inform precision phenotyping and targeted interventions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A narrative review was conducted integrating epidemiological, experimental, and clinical studies addressing sleep disorders and male reproductive outcomes, with emphasis on oxidative stress, inflammation, endocrine and metabolic dysregulation, circadian rhythm disruption, epigenetic regulation, and related therapeutic evidence.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Evidence indicates that sleep disorders compromise male fertility through converging mechanisms. Excessive reactive oxygen species (ROS) generation and chronic inflammatory activation directly damage testicular tissue and sperm DNA. Disruption of the hypothalamic–pituitary–gonadal (HPG) axis impairs testosterone synthesis and hormonal rhythmicity essential for spermatogenesis, while metabolic–endocrine dysregulation further exacerbates gonadal dysfunction. Circadian misalignment induces epigenetic reprogramming in spermatozoa, potentially mediating intergenerational reproductive effects. Integrating these findings, we propose the sleep–oxidative stress–circadian disruption–epigenetics–spermatogenesis axis as a unifying model linking sleep disorders to male infertility. Multimodal interventions, including continuous positive airway pressure (CPAP), antioxidant therapy, endocrine and metabolic modulation, circadian rhythm restoration, and cognitive-behavioral approaches, demonstrate potential to mitigate sleep-related reproductive impairment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sleep disorders represent clinically actionable contributors to male infertility. An integrated framework incorporating oxidative stress, ","PeriodicalId":7898,"journal":{"name":"Andrology","volume":"14 7","pages":"1941-1961"},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/andr.70191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical and Functional Outcomes of Penile Neurotization to Treat Post-Prostatectomy Erectile Dysfunction: Preliminary Results of a Novel Direct Somatic-to-Autonomic Procedure","authors":"Marco Falcone,&nbsp;Lorenzo Cirigliano,&nbsp;Ilaria Ferro,&nbsp;Roberto Carone,&nbsp;Davide Ciclamini,&nbsp;Mirko Preto,&nbsp;Natalia Plamadeala,&nbsp;Martina Scavone,&nbsp;Emanuele Zupo,&nbsp;Liliana Guadagni,&nbsp;Paolo Gontero","doi":"10.1111/andr.70182","DOIUrl":"10.1111/andr.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigate the preliminary surgical and functional outcomes of a new direct somatic-to-autonomic penile neurotization procedure transposing the gracilis branch of the obturator nerve to the corpora cavernosa bilaterally in patients affected by erectile dysfunction (ED) after radical prostatectomy (RP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A prospective trial was conducted to evaluate erectile function through validated questionnaires after the surgical procedure in patients after RP non-nerve sparing (NNS) (Group 1) or nerve sparing (NS) (Group 2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From October 2020 to January 2025, a total of 15 patients were enrolled in the study. Median age was 58 years (IQR: 54–61). 10 patients (66.7%) belong to the NS group while 5 (33.3%) underwent a NNS RP. The median time from RP to nerve transfer was 18 months (IQR: 13–26). No significant intraoperative or postoperative complications (greater than grade 1 according to Clavien-Dindo) were observed.</p>\u0000 \u0000 <p>As for functional results, a significant increase in median values of 3 validated questionnaires was noted at 24 months compared to the baseline evaluation. 41,7% of patients regained the ability to have satisfying sexual intercourse using PDE5i. The current sample size did not allow for a comparative analysis between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The preliminary outcomes of this pilot study indicate that the proposed technique appears feasible and safe, with early signals of potential benefit on erectile function. However, these findings are exploratory in nature and larger, well-designed are required to confirm the true clinical efficacy of this approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":"14 7","pages":"2057-2062"},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of microRNAs in the Regulation of Leydig Cell Function","authors":"Diwakar Kiduva Jothiraman,&nbsp;Lezy Flora Mariajoseph-Antony,&nbsp;Chithra Loganathan,&nbsp;Harshan Kannan,&nbsp;Kumarasamy Anbarasu,&nbsp;Chidambaram Prahalathan","doi":"10.1111/andr.70253","DOIUrl":"10.1111/andr.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>The study of male reproductive function is a critical area that requires an in-depth understanding of the underlying regulatory mechanisms. Male fertility has become a growing global health concern, driven by the increasing prevalence of hypogonadism and associated infertility. The existing treatment options for reproductive diseases have not achieved complete success, which highlights the need to explore novel therapeutic approaches. The malfunction and/or suppression of molecular regulators involved in the maintaining of cellular homeostasis under stress conditions have been identified as a key issue in Leydig cell insufficiency. miRNAs are noncoding RNA molecules that play a pivotal function in regulating gene expression and are implicated in diverse physiological and pathological conditions. In recent years, investigation into noncoding RNA-mediated gene repression has revealed new perspectives into the pathogenesis of testosterone insufficiency, including mitochondrial dysfunction, inflammation, steroidogenic impairment, cellular proliferation, and apoptosis. This review aims to understand the underlying mechanisms and interrelations between miRNAs and Leydig cell physiology/pathophysiology, which will enlighten innovative and effective strategies for hypogonadism-associated male infertility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":"14 7","pages":"2002-2017"},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/andr.70253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world pharmacovigilance assessment of drug-induced male hypogonadism risks: An analysis of FDA adverse drug event data","authors":"Yujia Xi,&nbsp;Yijun Jia,&nbsp;Zhanlong Zheng,&nbsp;Xinfang Cao,&nbsp;Zhinan Jing,&nbsp;Jingqi Wang","doi":"10.1111/andr.70120","DOIUrl":"10.1111/andr.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Drug-induced hypogonadism is an underrecognized but significant adverse effect of various medications, contributing to male sexual dysfunction and infertility. Despite its clinical significance, comprehensive studies systematically identifying high-risk drugs remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to investigate the potential drugs associated with hypogonadism from FDA Adverse Event Reporting System.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>This study analyzed adverse drug events reported from FDA Adverse Event Reporting System covering the period from the first quarter of 2004 to the third quarter of 2024. Cases related to hypogonadism were identified using standardized Medical Dictionary for Regulatory Activities preferred terms. Disproportionality analyses were conducted using the reporting odds ratio and the Bayesian confidence propagation neural network. Drugs were classified according to Anatomical Therapeutic Chemical classification system and clinical applications. This study utilized FDA Label to determine whether adverse drug events related to male hypogonadism are mentioned on their labels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 10 classes including 42 drugs that showed positive signals for both reporting odds ratio and Bayesian confidence propagation neural network: anesthetics and analgesics, psychiatric and neurological medications, antineoplastic agents, urological medications, hormonal agents, cardiovascular medications, gastrointestinal medications, bone metabolism modifiers, antiretroviral agents, and other drugs. According to the Bayesian confidence propagation neural network algorithm, 6 drugs were considered to have a high risk of causing hypogonadism, and 11 drugs had medium risk. In addition, 20 drugs did not mention adverse drug events related to male hypogonadism, of which 3 were identified as high risk using the Bayesian confidence propagation neural network algorithm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This research summarized a list of potential drugs associated with hypogonadism. A clear understanding of the risk and frequency of drug-induced hypogonadism can reduce the likelihood of patients developing the condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":"14 7","pages":"2105-2117"},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testicular Biopsies in Adolescent and Adult Andrological Patients: The EAA Clinical Guidelines","authors":"Lise Aksglaede,&nbsp;George Kanakis,&nbsp;Ewa Rajpert-De Meyts,&nbsp;Davor Jezek,&nbsp;Ferran Algaba,&nbsp;Gert Dohle,&nbsp;Jolanta Slowikowska-Hilczer,&nbsp;Sabine Kliesch,&nbsp;Hermann M. Behre,&nbsp;Csilla Krausz,&nbsp;Dimitrios G. Goulis,&nbsp;Niels Jørgensen","doi":"10.1111/andr.70300","DOIUrl":"10.1111/andr.70300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Histological evaluation of testicular tissue is central to the assessment of infertile men, particularly those at an increased risk of testicular germ cell tumors (TGCT). Traditionally, testicular biopsies have been used primarily for diagnostic purposes, such as the detection of germ cell neoplasia in situ (GCNIS). With advances in assisted reproductive technologies, testicular biopsies may also serve a therapeutic role, including testicular sperm extraction (TESE or microsurgical TESE) in men with nonobstructive azoospermia (NOA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide clinical practice guidelines on the indications for testicular biopsies for diagnostic and combined therapeutic–diagnostic purposes, including surgical aspects, tissue preparation and staining, and interpretation of histological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Evidence-based recommendations were developed following a systematic literature search of English-language publications and graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The suggestions and recommendations were thoroughly discussed by the guidelines’ authors, who are experienced in testicular biopsies in a clinical andrology setting. Subsequently, the guidelines were approved by the Directors of 29 andrological centers accredited by the European Academy of Andrology (EAA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 34 recommendations were formulated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Testicular biopsies remain an essential tool for both the diagnostic evaluation of men at risk of TGCT and therapeutic sperm retrieval in NOA. Careful patient selection, appropriate preoperative evaluation, and follow-up of reproductive hormones are crucial to optimize outcomes and minimize risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":"14 7","pages":"1906-1928"},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/andr.70300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boosting Male Fertility: The Impact of Gonadotropin Therapy on Hypogonadotropic Hypogonadism—A Systematic Review and Meta-Analysis","authors":"Manou Huijben,&nbsp;Anne Prinsen,&nbsp;Laetitia de Kort,&nbsp;Jetske van Breda","doi":"10.1111/andr.70226","DOIUrl":"10.1111/andr.70226","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Male hypogonadotropic hypogonadism typically presents with azoospermia and is one of the few causes of infertility amenable to a medical intervention. Gonadotropin therapy offers a chance to restore spermatogenesis and fertility in these individuals. Therefore, this study aims to determine the efficacy of gonadotropins in inducing spermatogenesis and achieving pregnancies in males with hypogonadotropic hypogonadism and azoospermia. Additionally, the time needed to induce spermatogenesis and pregnancy, and potential predictors associated with better outcomes, were evaluated.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A systematic literature search was conducted in the Medline, Embase, and Cochrane databases till May 16, 2025. Clinical studies, including randomized control trials, cohort studies, and case-control studies, using gonadotropins as a treatment for hypogonadotropic hypogonadism and assessing sperm induction or pregnancy outcomes, were eligible for inclusion. Primary outcomes included sperm parameters (appearance, concentration, motility, morphology, time needed to induce spermatogenesis) and pregnancy outcomes (pregnancy rate, proportion of naturally achieved pregnancies, proportion of live births, and time to conception). The methodological quality and risk of bias were assessed using the Effective Public Health Practice Project quality assessment tool for quantitative studies, and showed that most included studies were of poor methodological quality.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 50 studies were included from 2351 identified articles, treating 1583 male patients with hypogonadotropic hypogonadism and azoospermia. The pooled success rate of spermatogenesis induction was 74% (95% confidence interval: 66%–82%), with a mean time to spermatogenesis of 11.8 months. The overall pregnancy rate among couples with a child wish was 52% (95% confidence interval: 42%–62%), with a mean time to pregnancy from the start of treatment of 19 months. Mean post-treatment sperm concentration was 9.8 million/mL (95% confidence interval 8.6–11.0), and spontaneous pregnancies also occurred with suboptimal sperm parameters. Gonadotropin dual therapy was more effective than human chorionic gonadotropin monotherapy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Gonadotropin therapy, particularly combined gonadotropin treatment, is effective in restoring spermatogenesis and achieving pregnancy in men with hypogonadotropic hypogonadism. While sperm quality often remains below normal thresholds,","PeriodicalId":7898,"journal":{"name":"Andrology","volume":"14 7","pages":"1971-1987"},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/andr.70226","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep-Learning-Based Profiling of Mouse Sperm Head and Neck Morphology Reveals Coordinated Structural Variation.","authors":"Gwidong Han, Seung Pyo Hong, Seung Jae Lee, Chunghee Cho","doi":"10.1111/andr.70380","DOIUrl":"https://doi.org/10.1111/andr.70380","url":null,"abstract":"<p><strong>Background: </strong>Mammalian sperm head morphology varies across species and dictates fertilization capability. Rodent sperm have asymmetric, hook-shaped heads, complicating analysis. Despite widespread biomedical use, current tools poorly characterize these complex variations.</p><p><strong>Objectives: </strong>This study aimed to establish a robust framework for the precise, noninvasive, and quantitative analysis of mouse sperm morphology.</p><p><strong>Materials and methods: </strong>We developed ADAM-net (Anomaly-aware Deep-learning Architecture for Morphology), a machine-learning system for mouse sperm head and neck structures. Integrating a dataset preparation module, ResNet-18, and additional layers, it features two variants: ADAM-net-FL for fluorescence (FL) and ADAM-net-BF for bright-field (BF) images.</p><p><strong>Results: </strong>ADAM-net-BF enables simultaneous analysis of the head and neck using noninvasively acquired BF images. Atypical head shapes were frequently associated with a neck in which the tail is attached perpendicular to the head axis, revealing a specific relationship between head shape and tail attachment pattern. Additionally, ADAM-net provided novel quantitative insights into testicular germ cell-specific HSF2-interacting lncRNA (Teshl)-knockout sperm defects, supporting its utility for mouse sperm morphology analysis.</p><p><strong>Conclusion: </strong>ADAM-net provides a standard and facile tool that will have applications in various reproductive studies, extending to the exploration of subtle structural dynamics such as the sperm head-tail alignment.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}