MANILA,Philippines,May 29,2024 -- Spectacular advances in the diagnosis and treatment of male infertility are offering new hope to the one in six couples globally who seek assisted reproduction to achieve their dreams of parenthood.
A major conference on human reproduction in the Philippines this week addressed emerging frontiers of understanding about male infertility and sexual dysfunction that is responsible for about half of all causes of couples failing to conceive.
Eminent Indian andrologist and microsurgeon,Dr Rupin Shah,a keynote speaker at the 2024 Congress of the Asia Pacific Initiative on Reproduction (ASPIRE),said the treatment of male infertility was on the cusp of a scientific and medical revolution.
"In the past,semen analysis was the main test to label a man infertile," he explained. "However,we now recognise that measurement of sperm count and motility tells only part of the story.
"The World Health Organisation has taken the bold step of declaring that there is no definite reference value that can label one man infertile and another fertile.
"Therefore,future research is expected to quantify semen parameters on a continuum that gives the probability of fertility rather than a definite label of fertile or infertile."
Dr Shah said the future of male infertility treatment would be driven by automatic semen analysis powered by artificial intelligence along with compact computing power allowing home semen testing that will be convenient and private resulting in earlier detection and corrective procedures.
He said there would be a dynamic new focus on sperm DNA integrity and testing of genetic variants and defects analysed by AI programs that will lead to more personalised medicine and treatments tailored to specific individual profiles.
There will also be a growing need to address spermatotoxic agents impacting on male infertility.
"The radio waves that bombard us,the chemicals we inhale,the endocrine disruptors that permeate our food cycle,and the microplastics that we have unleashed into the environment all play havoc with our fertility,and it is no surprise that sperm counts have been plummeting globally," Dr Shah added.
"To safeguard our species,future tests of an infertile male will have to include an assessment of accumulated toxic products with subsequent treatments to neutralise these impacts.
"Fascinating evidence is also emerging that the paternal influence on the offspring is much more pervasive,and the father's health at the time of conception can impact the future health of the offspring through epigenetic modifications that alter the expression of the genes.
"In future,we can expect that male evaluation will include profiling of various mRNA markers in the semen to better understand the testicular function and sperm quality."
Dr Shah said the development of artificial sperm would represent a "final frontier" in the treatment of male infertility.
"In the body,can we introduce stem cells into a non-functioning testis and induce it to start making sperm?
"In the laboratory,can we take immature cells from which sperm develop and mature them into viable sperm,or can we take an early development stem cell (pluripotent) and coax it into growing and transforming into a sperm cell?
"Can we take a genetically defective cell,repair the genetic defect and then replace it in the testis where it will produce normal sperm?
"This all sounds far-fetched,but these things have already been achieved in animal studies. Only the final frontier remains – human application.
"Of course,there are many barriers to overcome. For example,how do we make the process efficient enough for routine use? Is it safe for the offspring? And what are the tricky ethical consequences of such treatments?
"However,the development of these revolutionary treatments in the future is very much a possibility."
For further information,go to the ASPIRE Congress website www.aspire2024.com
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