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Male infertility in Czech urological practice – current diagnostic and therapeutic trends


Authors: Marek Broul 1 3;  Aneta Hujová 3;  Michaela Liegertová 4
Authors‘ workplace: Sexuologické oddělení, Krajská zdravotní, a. s. – Masarykova nemocnice v Ústí nad Labem, o. z 1;  Urologické oddělení, Krajská zdravotní, a. s. – Nemocnice Litoměřice, o. z. 2;  Fakulta zdravotnických studií UJEP v Ústí nad Labem 3;  Přírodovědecká fakulta UJEP v Ústí nad Labem 4
Published in: Ces Urol 2025; 29(2): 86-93
Category: Review article
doi: https://doi.org/10.48095/cccu2025014

Overview

Male infertility is a multifactorial condition contributing to approximately 50% of all cases of couple infertility. In recent years, significant advances have been made in both diagnostics and treatment. This review summarizes key developments from 2019 to 2024 with direct relevance to routine clinical practice in Czech urology and andrology. Particular attention is paid to the updated semen analysis standards (World Health Organisation 6th edition, 2021), sperm DNA fragmentation testing, genetic evaluation (karyotyping, Y chromosome microdeletions, and exome sequencing), surgical management of varicocele, and sperm retrieval techniques for azoospermia, including microdissection testicular sperm extraction (micro-TESE). The article also discusses pharmacological options (gonadotropins, selective estrogen receptor modulators, antioxidants), the impact of lifestyle factors, and the importance of interdisciplinary collaboration with assisted reproduction centers. Future perspectives, including the role of preventive strategies in male reproductive health, are also addressed. The aim is to provide a comprehensive and clinically applicable overview of current recommendations and therapeutic approaches in andrology, with a focus on their implementation in the Czech urological setting.

Keywords:

male infertility – semen analysis – sperm DNA fragmentation – varicocele – micro- -TESE – assisted reproduction – genetic testing


Sources
  1. Novák J. Reprodukční medicína nejen pro urology. Praha: Maxdorf 2023.
  2. Uroweb. EAU Guidelines – Sexual and Reproductive Health [online]. Available from: https://uroweb.org/guidelines/sexual-and-reproductive-health.
  3. ESHRE. ESHRE Guidelines, Consensus Documents and Recommendations [online]. Available from: https://www.eshre.eu/Guidelines-and-Legal.
  4. World Health Organization. WHO laboratory manual for the examination and processing of human semen. Geneva: WHO 2021, 6th ed [online]. Available from: https://www.who.int/publications/i/item/9789240030787.
  5. Agarwal A, Majzoub A, Baskaran S et al. Sperm DNA fragmentation: a new guideline for clinicians. World J Mens Health 2020; 38(4): 412–471. doi: 10.5534/wjmh.200128.
  6. Sharma R, Iovine C, Agarwal A et al. TUNEL assay – standardized method for testing sperm DNA fragmentation. Andrologia 2021; 53(2): e13738. doi: 10.1111/and.13738.
  7. Ozkan E, Lacerda MP. Genetics, cytogenetic testing and conventional karyotype. In: StatPearls [online]. Treasure Island (FL): StatPearls Publishing 2025. Available from: http://www.ncbi.nlm.nih.gov/books/NBK563293/.
  8. Broul M, Lišková L, Kučerová P et al. Azoospermie při nálezu rozsáhlé přestavby Y chromozomu – isochromozomu i(Y)(p10). Ces Urol 2024; 28(1): 30–35. doi: 10.48095/cccu2023034.
  9. Friedman JM, Jones KL, Carey JC. Exome sequencing and clinical diagnosis. JAMA 2020; 324(7): 627–628. doi: 10.1001/jama.2020.11126.
  10. Marinaro J, Goldstein M. Current and future applications of artificial intelligence to diagnose and treat male infertility. Adv Exp Med Biol 2025; 1469: 1–23. doi: 10.1007/978-3-031-82990-1_1.
  11. Kočvara R, Novák K, Doležal J et al. Klinické a hormonální nálezy u dětí a dospívajících s varikokélou. Ces Urol 2000; 4(1): 27–31. doi: 10.48095/ cccu2000005.
  12. Drlík M, Kočvara R. Varikokéla. Urol Praxi 2019; 20(2): 66–69. doi: 10.36290/uro.2019.009.
  1. Graziani A, Grande G, Scafa R et al. Pharmacogenetics of follicle‐stimulating hormone action in the male. Andrology 2025. Ahead of print. doi: 10.1111/andr.70053.
  2. Al Hashimi M, Pinggera GM, Shah R et al. Clinician’s guide to the management of azoospermia induced by exogenous testosterone or anabolic androgenic steroids. Asian J Androl 2025; 27(3): 330–341. doi: 10.4103/aja2024104.
  3. Broul M, Laštůvková J, Čejnová V et al. Priapismus při substituční terapii testosteronem centrálního hypogonadismu. Ces Urol 2023; 27(2): 116– –121. doi: 10.48095/cccu2023016.
  4. Boussabbeh M, Haddar M, Sallem A et al. Enhancing male fertility: the role of crocin in boosting sperm motility through antioxidant activity and mitochondrial pathways. J Biochem Mol Toxicol 2025; 39(5): e70275. doi: 10.1002/jbt.70275.
  5. Bittner L, Chocholatý M, Čechová M et al. Vliv volných radikálů na fertilitu muže a možnosti léčby. Ces Urol 2015; 19(1): 11–18. doi: 10.48095/ cccu2015002.
  6. Osadchuk L, Kleshchev M, Osadchuk A. Effects of cigarette smoking on semen quality, reproductive hormone levels, metabolic profile, zinc and sperm DNA fragmentation in men: results from a population-based study. Front Endocrinol (Lausanne) 2023; 14: 1255304. doi: 10.3389/ fendo.2023.1255304.
  7. Finelli R, Mottola F, Agarwal A. Impact of alcohol consumption on male fertility potential: a narrative review. Int J Environ Res Public Health 2021; 19(1): 328. doi: 10.3390/ijerph19010328.
  8. Durairajanayagam D, Sharma RK, du Plessis SS et al. Testicular heat stress and sperm quality. In: Male infertility: a complete guide to lifestyle and environmental factors (pp. 105–125). New York: Springer 2014. Vickram SA, Bharath S, Durairaj JR et al. The role of environmental toxins in infertility: insights from cutting-edge research. Scripta Med
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