Статья
Areas of Controversy and Confusion in Male Infertility: A Call for Clarity
The pathogenesis of male infertility is multifaceted, driven by a convergence of congenital, acquired, and idiopathic influences that collectively disrupt spermatogenesis [1]. Despite major progress in diagnostic tools and treatment options, many areas in the management of male infertility are still inconsistent and lacking clear guidelines. Key challenges include the absence of objective protocols for assessing idiopathic male infertility (IMI) [2], ongoing debates about the usefulness of sperm DNA fragmentation (SDF) testing [3], and the management of high SDF [4,5]. Important choices, such as medical treatment before surgical sperm retrieval (SSR) in men with non-obstructive azoospermia (NOA) [6], management of leukocytospermia [7], or SSR in men with cryptozoospermia, often rely on clinicians’ preference and experience instead of strong clinical evidence. These inconsistencies highlight the urgent need for standardization and evidence-based improvements in male infertility practice. This editorial aims to underscore areas in male infertility where clinical controversies persist and to call for consensusdriven, evidence-based guidance.
