Surgical sperm retrieval in patients with nonmosaic Klinefelter syndrome (47,XXY) may be safely delayed until adulthood: a systematic review and meta-analysis.

Importance: Klinefelter syndrome (KS) is the most common genetic cause of azoospermia and results in germ cell apoptosis, seminiferous tubule hyalinization, and testicular interstitial hyperplasia. It remains controversial whether surgical sperm retrieval should be performed soon after puberty or may be safely delayed until adulthood.

Objective: To assess the relationship between age and surgical sperm retrieval success in patients with nonmosaic KS, with particular attention to outcomes in adolescence versus adulthood.

The Effects of Varicocele Repair on Testicular Sperm Retrieval, Sperm Recovery in the Ejaculate and Clinical Pregnancy Rates in Non-Obstructive Azoospermic Men with Clinical Varicocele: A Systematic Review and Meta-analysis.

Purpose: The role of varicocele repair (VR) in infertile men with non-obstructive azoospermia (NOA) and varicocele is controversial in the current guidelines, despite available studies. This study aims to assess the impact of VR on testicular sperm retrieval, sperm recovery from the ejaculate, and clinical pregnancy rates in infertile men with NOA and clinical varicocele through a systematic review and meta-analysis (SRMA) of controlled studies.

Materials And Methods: A systematic literature search was conducted using the Scopus and PubMed databases up to November 2023.

Short-term impact of tirzepatide on metabolic hypogonadism and body composition in patients with obesity: a controlled pilot study.

Background: Tirzepatide (TZP), a dual agonist of glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has recently been introduced in Italy for the treatment of obesity. Obesity is frequently associated with metabolic hypogonadism, which is characterized by low testosterone levels and normal low levels of gonadotropin. This condition exacerbates metabolic dysfunction and increases the risk of type 2 diabetes mellitus (DM).

Impact of Varicocele on Pregnancy and Live Birth Outcomes in Men with Clinical Varicocele: Systematic Review of Controlled Studies.

Purpose: To investigate the impact of varicocele on pregnancy and live birth outcomes in men with clinical varicocele in controlled studies.

Materials And Methods: A comprehensive literature search was conducted across the PubMed and Scopus databases using Boolean operators, covering all available records from each database's inception through June 30, 2024. The inclusion criteria focused on controlled studies that compared pregnancy-related outcomes-including pregnancy, miscarriage, and live birth rates-between men with clinical varicocele and those without.

The Global State of Contemporary Andrology Practice: A Comprehensive Analysis of Clinical Practice, Training Pathways, and Emerging Challenges.

Purpose: This study evaluates the current state of andrology practice worldwide, identifies challenges faced by clinicians, and explores training, certification, and research opportunities. It also seeks to redefine the qualifications necessary to be recognized as an andrologist and to propose areas for standardization and improvement.

Materials And Methods: A global, cross-sectional survey was conducted using a 48-question online questionnaire designed by international experts.

Development of a Training Program for Meta-Analytical Research: A Novel Approach to Minimizing Errors in Medical Systematic Reviews and Meta-Analyses.

Purpose: The Global Andrology Forum (GAF) has developed an innovative training method to equip novice researchers with the fundamental skills to conduct high-quality systematic reviews and meta-analyses (SRMAs) under the supervision of senior experts. This article aims to describe and evaluate the effectiveness of the GAF training program in enhancing these skills.

Materials And Methods: A six-module training program was designed to cover the key steps in SRMA studies, enabling GAF members to conduct high-quality SRMAs.

Global Andrology Forum (GAF) Clinical Guidelines on the Management of Non-obstructive Azoospermia: Bridging the Gap between Controversy and Consensus.

Purpose: Non-obstructive azoospermia (NOA), defined as the absence of sperm in the ejaculate due to testicular failure, is observed in 5% to 15% of infertile men and accounts for two-thirds of azoospermia cases. The management of NOA is marked by significant controversy and global variation in diagnostic and therapeutic approaches, highlighting the crucial need for well-designed and standardized clinical practice guidelines. We present comprehensive graded clinical practice recommendations and statements for diagnosing and treating NOA, aiming to establish standardized strategies that can globally help guide practitioners in their practice.

Sperm DNA Fragmentation in Men with Varicocele: A Systematic Review and Meta-Analysis.

Purpose: In this systematic review and meta-analysis, we investigated the relationship between varicocele and sperm DNA fragmentation (SDF) alongside conventional semen parameters.

Materials And Methods: A comprehensive systematic search was conducted to identify articles on SDF in men with varicocele published in the Scopus and PubMed databases. This included observational studies investigating levels of SDF as a primary outcome and conventional semen parameters as secondary outcomes in men with varicocele compared to men without varicocele.

A holistic view of SGLT2 inhibitors: From cardio-renal management to cognitive and andrological aspects.

Type 2 diabetes mellitus (T2DM) is a multifactorial disease associated with complications that significantly affect both survival and quality of life, including cardiovascular, renal, cognitive, sexual, and reproductive dysfunctions. Sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2is) have emerged as a transformative class of drugs, demonstrating benefits that extend beyond glycemic control. Large clinical trials have shown that SGLT2is reduce hospitalization for heart failure by 25-35% and slow progression of chronic kidney disease by 30-45%, with variation based on the specific agent, dose, and patient population.

Identification of Novel Genetic Variants in a Cohort of Congenital Hypogonadotropic Hypogonadism: Computational Analysis of Pathogenicity Predictions.

Congenital hypogonadotropic hypogonadism (CHH) is a rare and heterogeneous genetic disorder with variable penetrance caused by GnRH deficiency, leading to delayed puberty and infertility. In 50-60% of cases, CHH is associated with non-reproductive abnormalities, most commonly anosmia/hyposmia (Kallmann syndrome, KS). Over 60 genes have been implicated in CHH pathogenesis.

Effects of ketogenic diets on polycystic ovary syndrome: a systematic review and meta-analysis.

Background: This systematic review and meta-analysis aimed to evaluate the effects of ketogenic diet (KD) and very-low-energy ketogenic therapy (VLEKT) protocols on various health outcomes in patients with polycystic ovary syndrome (PCOS) and increased body weight.

Methods: A systematic search was conducted across Scopus, PubMed, Cochrane, and Embase databases from their inception through January 2025, using a predefined search strategy. Studies were selected based on the PICOS criteria.

Testosterone replacement therapy and spermatogenesis in reproductive age men.

Testosterone has a pivotal role in spermatogenesis, erectile function, libido and expression of secondary sexual characteristics. The prevalence of symptomatic, laboratory-proven testosterone deficiency increases with age and is often treated with testosterone replacement therapy (TRT). Treatment with exogenous androgens suppresses gonadotropin levels, inhibits endogenous testosterone production and drastically reduces intratesticular testosterone, consequently impairing spermatogenesis.

Persistence of hypertension after pregnancy-related hypertensive disorders in women with polycystic ovary syndrome.

Objective: To assess whether polycystic ovary syndrome (PCOS) increases the risk of persistent hypertension in women with a history of pregnancy-related hypertensive disorder (PHD).

Design: A single-center, prospective cohort study.

Subjects: A total of 124 patients with PHD were enrolled.

Testicular function and fertility outcomes in males with CF: A multi center retrospective study of men with congenital bilateral absence of the vas deferens based on CFTR mutation status.

Background: Modern cystic fibrosis (CF) treatments, particularly CFTR modulators, have allowed males with CF (MwCF) to live longer, healthier lives and pursue parenthood. Approximately 98% of MwCF have congenital bilateral absence of the vas deferens (CBAVD). While research shows MwCF experience spermatogenic dysfunction alongside obstructive azoospermia, understanding male reproductive health in MwCF remains limited.

Early Embryo Development: What Does Daddy Do?

Infertility represents a major global health challenge, with male infertility accounting for a significant proportion of cases, yet its underlying causes remain elusive in many instances. Traditionally, spermatozoa were viewed merely as DNA carriers, with little consideration given to their role beyond fertilization. Recent research, however, is challenging this view, revealing that spermatozoa are far more than passive delivery vehicles.

Retrospective real world study on vitamin D supplementation: Looking for the most effective molecule and its frequency of use.

Background & Aims: There is still uncertainty regarding the optimal serum levels 25-Hydroxy-vitamin D [25(OH)D] and the most effective supplementation strategies, including the choice of molecule and its dosing frequency. The aim of the study is to compare the effects of calcifediol versus two different frequencies of cholecalciferol administration on vitamin D supplementation, and to identity the key parameters that predict response to treatment.

Methods: This retrospective, real-world cohort study included 105 patients, who were divided into three groups.

Impact of automated insulin delivery (AID) systems on quality of life (QoL): Validation of the AID-QoL questionnaire.

Background And Aim: Evidence supports the efficacy of automated insulin delivery (AID) systems in improving glycometabolic outcomes. However, limited data are available on their impact on quality of life (QoL). This study aimed to develop and validate a questionnaire to assess QoL in subjects with type 1 diabetes mellitus (T1DM) using AID system (AID-QoL).

Gonadal function in patients with 47,XYY syndrome: a systematic review and meta-analysis.

The 47,XYY syndrome, or Jacobs syndrome, is a chromosomal disorder affecting approximately one in 1000 male births. While often asymptomatic or mildly expressed, it is associated with various physical, cognitive and behavioral features. Early studies erroneously linked the condition to aggressive behavior and elevated testosterone levels, largely based on incarcerated populations.

Deciphering Sperm-Carried IGF2 Transcript Variants: Cloning, qPCR Detection, and Variant Analysis.

Context: The insulin-like growth factor 2 (IGF2) gene, a paternally imprinted gene inactive in oocytes, plays a vital role in early embryo development. While 5 IGF2 variants have been described, the specific variants expressed in human spermatozoa compared to granulosa cells (GCs) remain unclear.

Objective: To characterize the quantity and variants of IGF2 transcripts expressed in human spermatozoa.

Global Andrology Forum Clinical Practice Guidelines on the Management of Premature Ejaculation.

Purpose: Premature ejaculation (PE) is a commonly encountered male sexual dysfunction (MSD) with various definitions, diagnostic criteria, and treatment options, leading to significant heterogeneity and controversy in its management. This study aimed to explore the global practice patterns of the diagnosis and management of PE.

Materials And Methods: A cross-sectional, global, online survey on PE was conducted using a questionnaire developed by an international cohort of experts.

Testicular function in postpubertal patients with growth hormone deficiency: A prospective controlled study.

Background: We have previously shown that treatment with recombinant human growth hormone (GH) influences testicular growth in children with GH deficiency (GHD) and have suggested that GH plays a role in testicular growth in childhood. Little evidence is available on testicular function in post-pubertal GHD patients.

Objective: This prospective controlled study was undertaken to evaluate testicular function in patients with GHD.

Reducing Quotation Errors in Scientific Manuscripts: A Novel Approach from the Global Andrology Forum.

Purpose: This study investigated 1) the frequency of quotation errors in multi-authored medical manuscripts in andrology, 2) analyzed common types of quotation errors and the methods used to rectify them, and 3) evaluated their impact on manuscript accuracy, credibility, and research conclusions.

Materials And Methods: Twelve manuscripts written by the Global Andrology Forum (GAF) members between 2023 and 2024 were randomly selected for this study. The manuscripts and "Quotation Verification Sheets" were analyzed by senior GAF researchers to detect the number and types of quotation errors.

The influence of seminal microbiota on human testicular steroidogenesis: a prospective study.

Objective: Preclinical evidence has demonstrated that gut microbiota composition can influence steroid hormone biosynthesis and spermatogenesis. This study aims to investigate the association of seminal microbiota and testicular steroidogenesis.

Patients And Methods: One hundred adult eugonadal men were consecutively enrolled.