Revolutionizing Male Infertility: Novel Mechanistic Insights, Diagnostic Innovations, and Management Strategies

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 2467

Special Issue Editor


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Guest Editor
Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
Interests: male infertility; male sexual dysfunction; female sexual dysfunction; couple sexual dysfunction; andrology
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Special Issue Information

Dear Colleagues,

In recent decades, there have been remarkable strides in the field of male infertility, particularly in developing innovative diagnostic procedures and technologies. These advancements have undeniably brought hope and relief to individuals and couples struggling with fertility issues. Nevertheless, it is imperative to acknowledge that a substantial cohort of patients still suffer from infertility problems despite these significant improvements.

In this Special Issue, we investigate the promising research horizons poised to redefine the landscape of male infertility diagnosis, assessment, and treatment. These groundbreaking developments could enhance our ability to address this complex issue effectively.

While we celebrate the progress made in male infertility diagnosis and treatment, we must remain vigilant in pursuing even more productive solutions. Integrating portable semen analysis, advanced ultrasound technology, and artificial intelligence will bring us into a new era of precision and success in addressing male infertility. With this, these emerging technologies hold the potential to offer renewed hope to those facing the challenging journey of building their families.   

Prof. Dr. Athanasios Zachariou
Guest Editor

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Keywords

  • male infertility
  • andrology
  • reproductive health
  • testis
  • spermatozoa
  • semen analysis
  • TESE
  • mTESE
  • ultrasound
  • artificial intelligence
  • IVF

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Published Papers (2 papers)

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Research

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11 pages, 475 KB  
Article
Longer Arousal, Better Semen: Effects of Extended Pre-Ejaculatory Arousal on Semen Parameters in Infertile Men
by Murat Beyatlı, Hasan Samet Güngör, Tuncel Uzel, Resul Sobay, Abdurrahman İnkaya, Mehmet Umut Evci, Rıdvan Özbek, Ahmet Tahra and Eyüp Veli Küçük
Diagnostics 2025, 15(24), 3186; https://doi.org/10.3390/diagnostics15243186 - 13 Dec 2025
Viewed by 1793
Abstract
Background/Objectives: To examine whether extending sexual arousal through lengthened erotic video viewing during semen collection improves semen parameters in infertile men. Methods: In this prospective within-subject study, 205 infertile men supplied semen samples in two sessions about four weeks apart and [...] Read more.
Background/Objectives: To examine whether extending sexual arousal through lengthened erotic video viewing during semen collection improves semen parameters in infertile men. Methods: In this prospective within-subject study, 205 infertile men supplied semen samples in two sessions about four weeks apart and followed strict uniform protocols. In the first session, participants ejaculated after the customary viewing length of erotic videos. During the second session, viewing time was increased prior to ejaculation. Semen volume, sperm concentration, total motility, progressive motility, and morphology were assessed as per the WHO 2021 guidelines. Comparisons were analyzed using paired samples t-test or Wilcoxon signed-rank test and correlation analysis was performed using Spearman’s rank correlation. Results: Median duration of erotic video watching increased from 8 min (IQR: 5–10) to 15 min (IQR: 11–20) (p < 0.001). Moreover, extended arousal was associated with increased sperm concentration (from 19 × 106/mL to 24 × 106/mL, p < 0.001), total motility (43% to 46%, p < 0.001), and progressive motility (33% to 37%, p < 0.001) with unchanged morphology (p = 0.053). Increases in arousal duration exhibited a weak but significant correlation with changes in concentration (ρ = 0.21, p = 0.003), total motility (ρ = 0.27, p < 0.001), and progressive motility (ρ = 0.22, p = 0.002). Subgroup analysis showed improvements in non-smokers but not in smokers. Conclusions: Extended erotic stimulation during semen sample collection significantly enhances sperm motility and modestly increases concentration in men with infertility, albeit without changing morphology. These findings suggest that extended erotic stimulation during semen collection may be a simple, non-invasive strategy to help optimize semen quality in infertile men, especially non-smokers. Full article
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Review

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27 pages, 901 KB  
Review
Prostatitis-Related Male Infertility: From Inflammation and Dysbiosis to Sperm DNA Damage
by Aris Kaltsas, Nikolaos Pantazis, Vasileios Tzikoulis, Christos Roidos, Natalia Palapela, Chara Tsiampali, Evangelos N. Symeonidis, Athanasios Zachariou, Nikolaos Sofikitis and Fotios Dimitriadis
Diagnostics 2026, 16(5), 722; https://doi.org/10.3390/diagnostics16050722 - 28 Feb 2026
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Abstract
Prostatitis includes infectious and noninfectious inflammatory phenotypes that can impair male reproductive potential and may influence couple-level reproduction via seminal inflammatory and microbial exposure. This review summarizes mechanisms linking prostatic inflammation and dysbiosis to semen dysfunction and sperm DNA damage and proposes an [...] Read more.
Prostatitis includes infectious and noninfectious inflammatory phenotypes that can impair male reproductive potential and may influence couple-level reproduction via seminal inflammatory and microbial exposure. This review summarizes mechanisms linking prostatic inflammation and dysbiosis to semen dysfunction and sperm DNA damage and proposes an infertility-oriented diagnostic and management framework. This is a narrative review of clinical and translational evidence addressing semen inflammation, oxidative stress, sperm DNA fragmentation (SDF), microbiome signatures, and reproductive outcomes in prostatitis (National Institutes of Health (NIH) categories I-IV). Across prostatitis phenotypes, leukocytospermia and elevated seminal cytokines (especially interleukin-8) are associated with impaired motility, altered viscosity and liquefaction, oxidative stress, and higher SDF. Persistent infection or dysbiosis may sustain immune activation and redox injury, while ductal remodeling and pain-related sexual dysfunction can further reduce natural conception. Seminal cytokines and microbes may affect female reproductive tract biology, although clinical outcome data remain limited. Prostatitis-related infertility requires evaluation beyond routine semen analysis. A biomarker-guided workup integrating inflammatory markers, oxidative stress testing, targeted microbiology (culture plus nucleic acid amplification tests when indicated), SDF testing in selected men, and imaging when obstruction is suspected can identify treatable drivers and guide timing and selection of assisted reproduction strategies. Future studies should standardize fertility endpoints and validate biomarker-guided and microbiome-directed interventions. Full article
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