The Genetics of Male Infertility and Clinical Implications

A special issue of Genes (ISSN 2073-4425). This special issue belongs to the section "Human Genomics and Genetic Diseases".

Deadline for manuscript submissions: 5 June 2026 | Viewed by 3353

Special Issue Editor


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Guest Editor
Endocrinology Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
Interests: male infertility; male hypogonadism; non-obstructive azoospermia; physiology of male fertility

Special Issue Information

Dear Colleagues,

Male infertility is a daily challenge for the clinical andrologist. Even after a thorough diagnostic work-up, about one-third of male infertility cases do not find an identifiable cause and remain defined as “idiopathic.”

However, the introduction of genetic investigation techniques, from classical PCR to next-generation sequencing platforms, has made it possible to identify many genetic determinants of infertility and shed light on previously unknown pathophysiological aspects. The finding of chromosomal abnormalities (e.g., sex chromosome aneuploidies, balanced and unbalanced translocations), Y-chromosome microdeletions, and genetic polymorphisms (e.g., the androgen receptor and FSH receptor) has become a common occurrence in practice. Consequently, knowledge of managing the clinical implications of these findings is mandatory.

An increasing interest in the genetics of male infertility has encouraged the formulation of this Special Issue. I therefore invite authors to submit original research articles, reviews, meta-analyses, concept papers, and commentaries that explore the pathophysiological aspects of infertility and apply such research data in clinical practice.  

Dr. Gianmaria Salvio
Guest Editor

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Keywords

  • genetics
  • male infertility
  • azoospermia
  • next generation sequencing
  • genetic variants

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Published Papers (3 papers)

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Research

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12 pages, 971 KB  
Article
The Expression of Kisspeptin Receptor, Catsper 3 and Acrosome Integrity in Oligozoospermic and Normozoospermic Individuals
by Nejat Ünlükal, Seda Aniç, Duygu Dursunoğlu, Seda Şimşek, Muslu Kazım Körez and Abdullah Şentürk
Genes 2026, 17(3), 266; https://doi.org/10.3390/genes17030266 - 26 Feb 2026
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Abstract
Background: Male infertility remains a significant clinical challenge. The KISS1R-CATSPER3 signaling axis and acrosomal integrity are vital for fertilization, yet their regional expression patterns in subfertile men are not fully characterized. Objectives: This study investigated regional expression patterns of KISS1R and [...] Read more.
Background: Male infertility remains a significant clinical challenge. The KISS1R-CATSPER3 signaling axis and acrosomal integrity are vital for fertilization, yet their regional expression patterns in subfertile men are not fully characterized. Objectives: This study investigated regional expression patterns of KISS1R and CATSPER3 and evaluated acrosomal integrity in oligozoospermic and normozoospermic individuals, accounting for demographic confounders. Methods: A total of 52 participants were selected from 568 candidates and divided into normozoospermic (n = 26) and oligozoospermic (n = 26) groups. Analysis included qPCR and immunofluorescence for KISS1R and CATSPER3. Regional expression was independently scored by blinded researchers. Statistical models were adjusted for age and body mass index (BMI). Results: Acrosomal integrity was significantly lower in the oligozoospermic group (p < 0.001). After adjusting for age and BMI, overall protein expression of CATSPER3 and KISS1R remained significantly lower in oligozoospermic men (p < 0.05). Regional analysis showed that CATSPER3 head staining differences disappeared after adjustment, whereas lower tail expression persisted. Higher KISS1R head expression in oligozoospermic men remained significant. qPCR showed no differences in KISS1R or CATSPER3 mRNA levels (p > 0.05), indicating post-translational regulation. Conclusions: KISS1R-CATSPER3 axis downregulation is a hallmark of oligozoospermia that persists independently of age and BMI. Regional protein instability, despite stable mRNA levels, suggests that post-translational regulation is critical for fertility. These markers may serve as potential diagnostic or therapeutic indicators for male infertility. Full article
(This article belongs to the Special Issue The Genetics of Male Infertility and Clinical Implications)
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Review

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30 pages, 759 KB  
Review
Genetic, Epigenetic, and Non-Genetic Factors in Testicular Dysgenesis Syndrome: A Narrative Review
by Alessandro Ciarloni, Nicola delli Muti, Sara Sacco, Nicola Ambo, Valentina Di Giacomi, Michele Perrone, Silvia Rossi, Marinella Balercia, Gianmaria Salvio and Giancarlo Balercia
Genes 2026, 17(1), 40; https://doi.org/10.3390/genes17010040 - 31 Dec 2025
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Abstract
Background: Testicular dysgenesis syndrome (TDS) is a complex disorder of the male reproductive system related to disfunction of the fetal testis. The clinical features of TDS may be evident at birth or infancy (cryptorchidism, hypospadias and/or reduced anogenital distance) or occur later in [...] Read more.
Background: Testicular dysgenesis syndrome (TDS) is a complex disorder of the male reproductive system related to disfunction of the fetal testis. The clinical features of TDS may be evident at birth or infancy (cryptorchidism, hypospadias and/or reduced anogenital distance) or occur later in adulthood (testis cancer, infertility). Genetic background seems to be important for genetic predisposition, with new genes being associated with components of the syndrome in last years. Interestingly, the incidence of clinical manifestations of TDS has been increasing in many countries in recent decades, suggesting that genetic predisposition alone cannot explain this trend. Consequently, the hypothesis of multifactorial etiopathogenesis is becoming increasingly accepted nowadays, with environmental factors probably acting during early developmental stages in genetically predisposed individuals. Methods: In this narrative review, we aim to critically evaluate genetic and non-genetic factors involved in the pathogenesis of TDs. Results: Important associations with intrauterine growth disorders and maternal diseases (overweight/obesity and diabetes) as well as lifestyle factors (e.g., smoking and alcohol abuse) were found. In such context, endocrine disruptors probably play a major role. These substances are widely used in industry and can exert estrogenic and antiandrogenic effects, potentially interfering with the development of the fetal gonad. Conclusions: Considering their possible impact on male sexual health, more attention should be focused on maternal modifiable factors to confirm with prospective studies the mixed results of available evidence. Full article
(This article belongs to the Special Issue The Genetics of Male Infertility and Clinical Implications)
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Other

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15 pages, 2792 KB  
Case Report
A Novel Variant of the ACTRT1 Gene Is Potentially Associated with Oligoasthenoteratozoospermia, Acrosome Detachment, and Fertilization Failure
by Olga Solovova, Sabina Khayat, Sergey Bogolyubov, Elizaveta Bragina, Tatiana Cherevatova and Vyacheslav Chernykh
Genes 2025, 16(12), 1422; https://doi.org/10.3390/genes16121422 - 28 Nov 2025
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Abstract
Background: Male infertility is a common reproductive disorder, affecting about 7% of men in the general population. Despite its prevalence, the cause of infertility is often unknown. This case report presents the results of a comprehensive evaluation of a patient with severe oligoasthenoteratozoospermia [...] Read more.
Background: Male infertility is a common reproductive disorder, affecting about 7% of men in the general population. Despite its prevalence, the cause of infertility is often unknown. This case report presents the results of a comprehensive evaluation of a patient with severe oligoasthenoteratozoospermia and primary infertility. Methods: The patient underwent clinical, andrological, and genetic examinations, including semen analysis, transmission electron microscopy, cytogenetic examination, molecular analysis of the AZF locus and the CFTR gene, whole-exome sequencing, and Sanger sequencing. Results: Semen analysis revealed severe oligoasthenoteratozoospermia. Transmission electron microscopy showed acrosome detachment from the nucleus in 49% of the spermatozoa. A high percentage (54%) of spermatozoa with insufficiently condensed (“immature”) chromatin was also observed. No chromosomal abnormalities, Y chromosome microdeletions, or pathogenic CFTR gene variants were identified. Whole-exome sequencing revealed a novel c.821G>C variant (chrX:127185365G>C; NM_138289.4) in the ACTRT1 gene (Xq25). This variant was hemizygous in the patient and heterozygous in his mother, as determined by Sanger sequencing. According to the ACMG guidelines (PM2, PP3), this missense variant in the ACTRT1 gene was classified as a variant of uncertain clinical significance (VUS). Amino acid conservation and 3D protein modeling predict that the identified variant has a deleterious effect on the protein. Conclusions: This study suggests a potential link between a novel ACTRT1 variant and a specific teratozoospermia phenotype. Further functional studies are needed to confirm this association and determine the role of the gene in X-linked male infertility. Full article
(This article belongs to the Special Issue The Genetics of Male Infertility and Clinical Implications)
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