Published 05 July 2022
A call for more research, more funding and more interest in male infertility and its treatment was made at an invited session at this annual meeting. Male factor infertility remains a major contributing factor to the continued expansion of assisted reproduction, even though fundamental questions in its biology and prevalence remain unanswered.
Canadian andrologist Chris De Jonge, one of the founding members of the Male Reproductive Health Initiative, explained the rationale for the group’s formation four years ago as the disappointing results obtained by a WHO-commissioned panel of experts; they were unable to answer essential questions on male reproductive health because of poor or no research on important topics, leaving major gaps in their evidence base. The expert panel concluded that only high quality evidence provided by multicentre research could ever fill the gaps.(1)
The overarching themes identified as a primary focus for MRHI were defined in 2018 and included basic research on male germ cell production and transformation into functional gametes - with the identification of vulnerability to such external factors as diet, lifestyle, medical and other environmental exposures. In addition, MRHI has an aim to improve the diagnosis of male infertility by identifying measurable and quantifiable aspects of sperm function, which might ultimately steer the manipulation of male fertility towards both conception and contraception.
MRHI also has eyes on long term follow-up, looking beyond the current generation of males to understand the long-term health outcomes of children fathered by men with compromised fertility, including those who may have had ART. ‘Society needs to be informed of what we learn from studying male reproductive fitness and health risks, with a focus on specific geographical areas,’ said De Jonge.
The MRHI’s first call to arms came in 2019 when the American Society of Andrology sponsored a workshop aiming to formulate specific strategies which were missing or under-addressed but vital to male health. The workshop included scientists, clinicians, funding agencies, industry representatives and patient support groups, a clear recognition, said De Jonge, that it takes the entire community to address the questions now being asked on male reproductive health.
MRHI was thus formally introduced to the world as a newly established and rapidly growing consortium of key opinion leaders in research, medicine, funding and policy agencies and patient support groups all then moving towards the goals of a strategic roadmap.(2) The purpose of this paper was to spotlight emerging and concerning data on male reproductive health, the relationship between male reproductive and somatic health, and the heritable conditions which fathers can pass to offspring. The paper also acknowledged increasing the awareness of men in their society, the participation of men in health seeking, and advocacy to invigorate policy and funding to support increased research into male reproductive biology.
De Jonge took a deep dive into the UK and USA’s funding of male and female reproductive research to reveal their disproportionately low levels of expenditure, despite the increasing global fertility risk for so many millions of couples. Male and female reproduction research funding is far below what would be expected given the classification of infertility as a disease, and with its frequent diagnoses and treatment.(3)
The presentation was concluded with an invitation to complete a new global questionnaire for the assessment of male attitudes towards infertility, and to a Campus meeting on male reproductive health in October in Budapest.(4,5)
1. Barratt CLR, Björndahl L, De Jonge CJ, et al. The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance-challenges and future research opportunities. Hum Reprod Update 2017; 23: 660-680.
2. De Jonge C, Barratt CLR. The present crisis in male reproductive health: an urgent need for a political, social, and research roadmap. Andrology 2019; 7: 762-768. doi:10.1111/andr.12673.
3. Gumerova E, De Jonge CJ, Barratt CLR. Research funding for male reproductive health and infertility in the UK and USA [2016 - 2019]. Hum Fertil 2022: 1-11. doi:10.1080/14647273.2022.2045521.
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