TY  - JOUR
T1  - Areas of Controversy and Confusion in Male Infertility: A Call for Clarity
JF  - THE WORLD JOURNAL OF MEN'S HEALTH
DO  - 10.5534/wjmh.250269
AU  - Mohamed Arafa, 
AU  - Tuncay Toprak, 
AU  - Edmund Ko, 
AU  - Rupin Shah, 
AU  - Armand Zini, 
AU  - Eric Chung, 
AU  - Selahittin Cayan, 
AU  - Germar-Michael Pinggera, 
AU  - Widi Atmoko, 
AU  - Tan Le, 
AU  - Ayman Rashed, 
AU  - Taras Shatylko, 
AU  - Akira Tsujimura, 
AU  - Hyun Jun Park, 
AU  - Hussein Kandil, 
AU  - Manaf Al Hashmi, 
AU  - Marco Falcone, 
AU  - Celeste Manfredi, 
AU  - Haocheng Lin, 
AU  - Andrian Japari, 
AU  - Manh Nguyen Truong, 
AU  - Mohammed Abdulgabbar Noman, 
AU  - Jean de la Rosette, 
AU  - Walter D. Cardona Maya, 
AU  - Ashok Agarwal, 
Y1  - 2026-06-16
UR  - https://repo.bashgmu.ru/publication/5524
N2  - 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.