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Journal of Endocrinological Investigation

Erschienen in:

01.05.2022 | Consensus Statement

Management of male factor infertility: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS)

Endorsing Organization: Italian Society of Embryology, Reproduction, and Research (SIERR)

verfasst von: A. Ferlin, A. E. Calogero, C. Krausz, F. Lombardo, D. Paoli, R. Rago, C. Scarica, M. Simoni, C. Foresta, V. Rochira, E. Sbardella, S. Francavilla, G. Corona

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 5/2022

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Abstract

Purpose

Infertility affects 15–20% of couples and male factors are present in about half of the cases. For many aspects related to the diagnostic and therapeutic approach of male factor infertility, there is no general consensus, and the clinical approach is not uniform.

Methods

In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), endorsed by the Italian Society of Embryology, Reproduction, and Research (SIERR), we propose evidence-based recommendations for the diagnosis, treatment, and management of male factor infertility to improve patient and couple care.

Results

Components of the initial evaluation should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, and imaging are suggested in most men and recommended when specific risk factors for infertility exist or first-step analyses showed abnormalities. Full examination including genetic tests, testicular cytology/histology, or additional tests on sperm is clinically oriented and based on the results of previous investigations. For treatment purposes, the identification of the specific cause and the pathogenetic mechanism is advisable. At least, distinguishing pre-testicular, testicular, and post-testicular forms is essential. Treatment should be couple-oriented, including lifestyle modifications, etiologic therapies, empirical treatments, and ART on the basis of best evidence and with a gradual approach.

Conclusion

These Guidelines are based on two principal aspects: they are couple-oriented and place high value in assessing, preventing, and treating risk factors for infertility. These Guidelines also highlighted that male infertility and in particular testicular function might be a mirror of general health of a man.

Nur mit Berechtigung zugänglich

Tournaye H, Krausz C, Oates RD (2017) Concepts in diagnosis and therapy for male reproductive impairment. Lancet Diabetes Endocrinol 5(7):554–564. https://doi.org/10.1016/S2213-8587(16)30043-2CrossRefPubMed

Ferlin A, Garolla A, Ghezzi M, Selice R, Palego P, Caretta N et al (2019) Sperm count and hypogonadism as markers of general male health. Eur Urol Focus. https://doi.org/10.1016/j.euf.2019.08.001CrossRefPubMed

Association MIBPPCotAU, Medicine PCotASfR (2006) Report on optimal evaluation of the infertile male. Fertil Steril 86(5 Suppl 1):S202–S209. https://doi.org/10.1016/j.fertnstert.2006.08.029CrossRef

Salonia A, Bettocchi C, Carvalho J, Corona G, Jones T, Kadjoglu A et al (2020) EAU Guidelines on Sexual and Reproductive Health. European Association of Urology 2020

(UK) NIfHaCE (2016) Addendum to Clinical Guideline 156, Fertility problems: assessment and treatment

Medicine PCotASfR (2015) Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril 103(3):e18-25. https://doi.org/10.1016/j.fertnstert.2014.12.103CrossRef

Esteves SC, Chan P (2015) A systematic review of recent clinical practice guidelines and best practice statements for the evaluation of the infertile male. Int Urol Nephrol 47(9):1441–1456. https://doi.org/10.1007/s11255-015-1059-0CrossRefPubMed

Colpi GM, Francavilla S, Haidl G, Link K, Behre HM, Goulis DG et al (2018) European Academy of Andrology guideline Management of oligo-astheno-teratozoospermia. Andrology 6(4):513–524. https://doi.org/10.1111/andr.12502CrossRefPubMed

Ferlin A, Foresta C (2020) Infertility: practical clinical issues for routine investigation of the male partner. J Clin Med. https://doi.org/10.3390/jcm9061644CrossRefPubMedPubMedCentral

10.

Schlegel PN, Sigman M, Collura B, De Jonge CJ, Eisenberg ML, Lamb DJ et al (2021) Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. Fertil Steril 115(1):54–61. https://doi.org/10.1016/j.fertnstert.2020.11.015CrossRefPubMed

11.

Schlegel PN, Sigman M, Collura B, De Jonge CJ, Eisenberg ML, Lamb DJ et al (2021) Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II. Fertil Steril 115(1):62–69. https://doi.org/10.1016/j.fertnstert.2020.11.016CrossRefPubMed

12.

Swiglo BA, Murad MH, Schünemann HJ, Kunz R, Vigersky RA, Guyatt GH et al (2008) A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system. J Clin Endocrinol Metab 93(3):666–673. https://doi.org/10.1210/jc.2007-1907CrossRefPubMed

13.

Nieschlag E (2010) Clinical trials in male hormonal contraception. Contraception 82(5):457–470. https://doi.org/10.1016/j.contraception.2010.03.020CrossRefPubMed

14.

Zitzmann M, Aksglaede L, Corona G, Isidori AM, Juul A, T’Sjoen G et al (2021) European academy of andrology guidelines on Klinefelter Syndrome Endorsing Organization: European Society of Endocrinology. Andrology 9(1):145–167. https://doi.org/10.1111/andr.12909CrossRefPubMed

15.

Hanson BM, Eisenberg ML, Hotaling JM (2018) Male infertility: a biomarker of individual and familial cancer risk. Fertil Steril 109(1):6–19. https://doi.org/10.1016/j.fertnstert.2017.11.005CrossRefPubMed

16.

Barratt CLR, Björndahl L, De Jonge CJ, Lamb DJ, Osorio Martini F, McLachlan R et al (2017) 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 23(6):660–680. https://doi.org/10.1093/humupd/dmx021CrossRefPubMedPubMedCentral

17.

Tournaye H, Krausz C, Oates RD (2017) Novel concepts in the aetiology of male reproductive impairment. Lancet Diabetes Endocrinol 5(7):544–553. https://doi.org/10.1016/S2213-8587(16)30040-7CrossRefPubMed

18.

WHO (2021) WHO laboratory manual for the examination and processing of human semen, 6th edn. WHO, Geneva

19.

Leushuis E, van der Steeg JW, Steures P, Repping S, Bossuyt PM, Blankenstein MA et al (2010) Reproducibility and reliability of repeated semen analyses in male partners of subfertile couples. Fertil Steril 94(7):2631–2635. https://doi.org/10.1016/j.fertnstert.2010.03.021CrossRefPubMed

20.

Ombelet W, Dhont N, Thijssen A, Bosmans E, Kruger T (2014) Semen quality and prediction of IUI success in male subfertility: a systematic review. Reprod Biomed Online 28(3):300–309. https://doi.org/10.1016/j.rbmo.2013.10.023CrossRefPubMed

21.

Ford WC (2010) Comments on the release of the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen. Asian J Androl 12(1):59–63. https://doi.org/10.1038/aja.2008.57CrossRefPubMedPubMedCentral

22.

Paoli D, Pecora G, Pallotti F, Faja F, Pelloni M, Lenzi A et al (2019) Cytological and molecular aspects of the ageing sperm. Hum Reprod 34(2):218–227. https://doi.org/10.1093/humrep/dey357CrossRefPubMed

23.

Semet M, Paci M, Saïas-Magnan J, Metzler-Guillemain C, Boissier R, Lejeune H et al (2017) The impact of drugs on male fertility: a review. Andrology 5(4):640–663. https://doi.org/10.1111/andr.12366CrossRefPubMed

24.

Hanson BM, Aston KI, Jenkins TG, Carrell DT, Hotaling JM (2018) The impact of ejaculatory abstinence on semen analysis parameters: a systematic review. J Assist Reprod Genet 35(2):213–220. https://doi.org/10.1007/s10815-017-1086-0CrossRefPubMed

25.

Verón GL, Tissera AD, Bello R, Beltramone F, Estofan G, Molina RI et al (2018) Impact of age, clinical conditions, and lifestyle on routine semen parameters and sperm kinematics. Fertil Steril 110(1):68-75.e4. https://doi.org/10.1016/j.fertnstert.2018.03.016CrossRefPubMed

26.

Gandini L, Menditto A, Chiodo F, Lenzi A (2000) From the European Academy of Andrology. Italian pilot study for an external quality control scheme in semen analysis and antisperm antibiotics detection. Int J Androl 23(1):1–3. https://doi.org/10.1046/j.1365-2605.2000.00208.xCrossRefPubMed

27.

Mallidis C, Cooper TG, Hellenkemper B, Lablans M, Uckert F, Nieschlag E (2012) Ten years’ experience with an external quality control program for semen analysis. Fertil Steril 98(3):611–6.e4. https://doi.org/10.1016/j.fertnstert.2012.05.006CrossRefPubMed

28.

Filimberti E, Degl’Innocenti S, Borsotti M, Quercioli M, Piomboni P, Natali I et al (2013) High variability in results of semen analysis in andrology laboratories in Tuscany (Italy): the experience of an external quality control (EQC) programme. Andrology 1(3):401–407. https://doi.org/10.1111/j.2047-2927.2012.00042.xCrossRefPubMed

29.

Mehta A, Sigman M (2015) Management of the dry ejaculate: a systematic review of aspermia and retrograde ejaculation. Fertil Steril 104(5):1074–1081. https://doi.org/10.1016/j.fertnstert.2015.09.024CrossRefPubMed

30.

Cui D, Han G, Shang Y, Liu C, Xia L, Li L et al (2015) Antisperm antibodies in infertile men and their effect on semen parameters: a systematic review and meta-analysis. Clin Chim Acta 444:29–36. https://doi.org/10.1016/j.cca.2015.01.033CrossRefPubMed

31.

Barbonetti A, Castellini C, D’Andrea S, Cordeschi G, Santucci R, Francavilla S et al (2019) Prevalence of anti-sperm antibodies and relationship of degree of sperm auto-immunization to semen parameters and post-coital test outcome: a retrospective analysis of over 10 000 men. Hum Reprod 34(5):834–841. https://doi.org/10.1093/humrep/dez030CrossRefPubMed

32.

Chiu WW, Chamley LW (2004) Clinical associations and mechanisms of action of antisperm antibodies. Fertil Steril 82(3):529–535. https://doi.org/10.1016/j.fertnstert.2003.09.084CrossRefPubMed

33.

Paoli D, Gilio B, Piroli E, Gallo M, Lombardo F, Dondero F et al (2009) Testicular tumors as a possible cause of antisperm autoimmune response. Fertil Steril 91(2):414–419. https://doi.org/10.1016/j.fertnstert.2007.11.084CrossRefPubMed

34.

Zini A, Fahmy N, Belzile E, Ciampi A, Al-Hathal N, Kotb A (2011) Antisperm antibodies are not associated with pregnancy rates after IVF and ICSI: systematic review and meta-analysis. Hum Reprod 26(6):1288–1295. https://doi.org/10.1093/humrep/der074CrossRefPubMed

35.

Patassini C, Garolla A, Bottacin A, Menegazzo M, Speltra E, Foresta C et al (2013) Molecular karyotyping of human single sperm by array- comparative genomic hybridization. PLoS ONE 8(4):e60922. https://doi.org/10.1371/journal.pone.0060922CrossRefPubMedPubMedCentral

36.

Templado C, Uroz L, Estop A (2013) New insights on the origin and relevance of aneuploidy in human spermatozoa. Mol Hum Reprod 19(10):634–643. https://doi.org/10.1093/molehr/gat039CrossRefPubMed

37.

Ioannou D, Fortun J, Tempest HG (2019) Meiotic nondisjunction and sperm aneuploidy in humans. Reproduction 157(1):R15–R31. https://doi.org/10.1530/REP-18-0318CrossRefPubMed

38.

Paoli D, Pallotti F, Lenzi A, Lombardo F (2018) Fatherhood and sperm DNA damage in testicular cancer patients. Front Endocrinol (Lausanne) 9:506. https://doi.org/10.3389/fendo.2018.00506CrossRef

39.

Muratori M, Marchiani S, Tamburrino L, Baldi E (2019) Sperm DNA fragmentation: mechanisms of origin. Adv Exp Med Biol 1166:75–85. https://doi.org/10.1007/978-3-030-21664-1_5CrossRefPubMed

40.

Carlini T, Paoli D, Pelloni M, Faja F, Dal Lago A, Lombardo F et al (2017) Sperm DNA fragmentation in Italian couples with recurrent pregnancy loss. Reprod Biomed Online 34(1):58–65. https://doi.org/10.1016/j.rbmo.2016.09.014CrossRefPubMed

41.

Roessner C, Paasch U, Kratzsch J, Glander HJ, Grunewald S (2012) Sperm apoptosis signalling in diabetic men. Reprod Biomed Online 25(3):292–299. https://doi.org/10.1016/j.rbmo.2012.06.004CrossRefPubMed

42.

Wang YJ, Zhang RQ, Lin YJ, Zhang RG, Zhang WL (2012) Relationship between varicocele and sperm DNA damage and the effect of varicocele repair: a meta-analysis. Reprod Biomed Online 25(3):307–314. https://doi.org/10.1016/j.rbmo.2012.05.002CrossRefPubMed

43.

Moskovtsev SI, Mullen JB, Lecker I, Jarvi K, White J, Roberts M et al (2010) Frequency and severity of sperm DNA damage in patients with confirmed cases of male infertility of different aetiologies. Reprod Biomed Online 20(6):759–763. https://doi.org/10.1016/j.rbmo.2010.03.002CrossRefPubMed

44.

Robinson L, Gallos ID, Conner SJ, Rajkhowa M, Miller D, Lewis S et al (2012) The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. Hum Reprod 27(10):2908–2917. https://doi.org/10.1093/humrep/des261CrossRefPubMed

45.

Simon L, Zini A, Dyachenko A, Ciampi A, Carrell DT (2017) A systematic review and meta-analysis to determine the effect of sperm DNA damage on. Asian J Androl 19(1):80–90. https://doi.org/10.4103/1008-682X.182822CrossRefPubMed

46.

Pacey A (2018) Is sperm DNA fragmentation a useful test that identifies a treatable cause of male infertility? Best Pract Res Clin Obstet Gynaecol 53:11–19. https://doi.org/10.1016/j.bpobgyn.2018.09.003CrossRefPubMed

47.

Purvis K, Christiansen E (1993) Infection in the male reproductive tract. Impact, diagnosis and treatment in relation to male infertility. Int J Androl 16(1):1–13. https://doi.org/10.1111/j.1365-2605.1993.tb01146.xCrossRefPubMed

48.

Elia J, Delfino M, Imbrogno N, Capogreco F, Lucarelli M, Rossi T et al (2009) Human semen hyperviscosity: prevalence, pathogenesis and therapeutic aspects. Asian J Androl 11(5):609–615. https://doi.org/10.1038/aja.2009.46CrossRefPubMedPubMedCentral

49.

Bundrick W, Heron SP, Ray P, Schiff WM, Tennenberg AM, Wiesinger BA et al (2003) Levofloxacin versus ciprofloxacin in the treatment of chronic bacterial prostatitis: a randomized double-blind multicenter study. Urology 62(3):537–541. https://doi.org/10.1016/s0090-4295(03)00565-xCrossRefPubMed

50.

Giannarini G, Mogorovich A, Valent F, Morelli G, De Maria M, Manassero F et al (2007) Prulifloxacin versus levofloxacin in the treatment of chronic bacterial prostatitis: a prospective, randomized, double-blind trial. J Chemother 19(3):304–308. https://doi.org/10.1179/joc.2007.19.3.304CrossRefPubMed

51.

Safarinejad MR (2008) Once-daily high-dose pindolol for paroxetine-refractory premature ejaculation: a double-blind, placebo-controlled and randomized study. J Clin Psychopharmacol 28(1):39–44. https://doi.org/10.1097/jcp.0b013e31816073a5CrossRefPubMed

52.

Busetto GM, Giovannone R, Ferro M, Tricarico S, Del Giudice F, Matei DV et al (2014) Chronic bacterial prostatitis: efficacy of short-lasting antibiotic therapy with prulifloxacin (Unidrox®) in association with saw palmetto extract, lactobacillus sporogens and arbutin (Lactorepens®). BMC Urol 14:53. https://doi.org/10.1186/1471-2490-14-53CrossRefPubMedPubMedCentral

53.

Maeda S, Deguchi T, Ishiko H, Matsumoto T, Naito S, Kumon H et al (2004) Detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in patients with non-gonococcal urethritis using polymerase chain reaction-microtiter plate hybridization. Int J Urol 11(9):750–754. https://doi.org/10.1111/j.1442-2042.2004.00887.xCrossRefPubMed

54.

Huang C, Zhu HL, Xu KR, Wang SY, Fan LQ, Zhu WB (2015) Mycoplasma and ureaplasma infection and male infertility: a systematic review and meta-analysis. Andrology 3(5):809–816. https://doi.org/10.1111/andr.12078CrossRefPubMed

55.

La Vignera S, Condorelli RA, Vicari E, Salmeri M, Morgia G, Favilla V et al (2014) Microbiological investigation in male infertility: a practical overview. J Med Microbiol 63(Pt 1):1–14. https://doi.org/10.1099/jmm.0.062968-0CrossRefPubMed

56.

Magid DJ, Stiffman M, Anderson LA, Irwin K, Lyons EE (2003) Adherence to CDC STD guideline recommendations for the treatment of Chlamydia trachomatis infection in two managed care organizations. Sex Transm Dis 30(1):30–32. https://doi.org/10.1097/00007435-200301000-00007CrossRefPubMed

57.

Prevention CfDCa (2014) Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae–2014. MMWR Recomm Rep 63(RR-02):1–19

58.

Zakher B, Cantor AG, Pappas M, Daeges M, Nelson HD (2014) Screening for gonorrhea and Chlamydia: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 161(12):884–893. https://doi.org/10.7326/M14-1022CrossRefPubMed

59.

Lunny C, Taylor D, Hoang L, Wong T, Gilbert M, Lester R et al (2015) Self-collected versus clinician-collected sampling for Chlamydia and Gonorrhea screening: a systemic review and meta-analysis. PLoS ONE 10(7):e0132776. https://doi.org/10.1371/journal.pone.0132776CrossRefPubMedPubMedCentral

60.

Jensen JS, Björnelius E, Dohn B, Lidbrink P (2004) Use of TaqMan 5’ nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic. J Clin Microbiol 42(2):683–692. https://doi.org/10.1128/JCM.42.2.683-692.2004CrossRefPubMedPubMedCentral

61.

Gaydos CA, Manhart LE, Taylor SN, Lillis RA, Hook EW, Klausner JD et al (2019) Molecular testing for Mycoplasma genitalium in the United States: results from the AMES prospective multicenter clinical study. J Clin Microbiol. https://doi.org/10.1128/JCM.01125-19CrossRefPubMedPubMedCentral

62.

Hamasuna R, Osada Y, Jensen JS (2007) Isolation of Mycoplasma genitalium from first-void urine specimens by coculture with Vero cells. J Clin Microbiol 45(3):847–850. https://doi.org/10.1128/JCM.02056-06CrossRefPubMedPubMedCentral

63.

Jordan SJ, Schwebke JR, Aaron KJ, Van Der Pol B, Hook EW (2017) Meatal swabs contain less cellular material and are associated with a decrease in gram stain smear quality compared to urethral swabs in men. J Clin Microbiol 55(7):2249–2254. https://doi.org/10.1128/JCM.00423-17CrossRefPubMedPubMedCentral

64.

Lyu Z, Feng X, Li N, Zhao W, Wei L, Chen Y et al (2017) Human papillomavirus in semen and the risk for male infertility: a systematic review and meta-analysis. BMC Infect Dis 17(1):714. https://doi.org/10.1186/s12879-017-2812-zCrossRefPubMedPubMedCentral

65.

Weinberg M, Sar-Shalom Nahshon C, Feferkorn I, Bornstein J (2020) Evaluation of human papilloma virus in semen as a risk factor for low sperm quality and poor in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril 113(5):955–69.e4. https://doi.org/10.1016/j.fertnstert.2020.01.010CrossRefPubMed

66.

Cao X, Wei R, Zhang X, Zhou J, Lou J, Cui Y (2020) Impact of human papillomavirus infection in semen on sperm progressive motility in infertile men: a systematic review and meta-analysis. Reprod Biol Endocrinol 18(1):38. https://doi.org/10.1186/s12958-020-00604-0CrossRefPubMedPubMedCentral

67.

Moreno-Sepulveda J, Rajmil O (2021) Seminal human papillomavirus infection and reproduction: a systematic review and meta-analysis. Andrology 9(2):478–502. https://doi.org/10.1111/andr.12948CrossRefPubMed

68.

Dize L, Agreda P, Quinn N, Barnes MR, Hsieh YH, Gaydos CA (2013) Comparison of self-obtained penile-meatal swabs to urine for the detection of C. trachomatis, N. gonorrhoeae and T. vaginalis. Sex Transm Infect. 89(4):305–307. https://doi.org/10.1136/sextrans-2012-050686CrossRefPubMed

69.

Chernesky MA, Jang D, Portillo E, Smieja M, Gilchrist J, Ewert R et al (2013) Self-collected swabs of the urinary meatus diagnose more Chlamydia trachomatis and Neisseria gonorrhoeae infections than first catch urine from men. Sex Transm Infect 89(2):102–104. https://doi.org/10.1136/sextrans-2012-050573CrossRefPubMed

70.

Coorevits L, Traen A, Bingé L, Van Dorpe J, Praet M, Boelens J et al (2018) Identifying a consensus sample type to test for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and human papillomavirus. Clin Microbiol Infect 24(12):1328–1332. https://doi.org/10.1016/j.cmi.2018.03.013CrossRefPubMed

71.

Plant TM, Marshall GR (2001) The functional significance of FSH in spermatogenesis and the control of its secretion in male primates. Endocr Rev 22(6):764–786. https://doi.org/10.1210/edrv.22.6.0446CrossRefPubMed

72.

Taieb J, Mathian B, Millot F, Patricot MC, Mathieu E, Queyrel N et al (2003) Testosterone measured by 10 immunoassays and by isotope-dilution gas chromatography-mass spectrometry in sera from 116 men, women, and children. Clin Chem 49(8):1381–1395. https://doi.org/10.1373/49.8.1381CrossRefPubMed

73.

Shea JL, Wong PY, Chen Y (2014) Free testosterone: clinical utility and important analytical aspects of measurement. Adv Clin Chem 63:59–84. https://doi.org/10.1016/b978-0-12-800094-6.00002-9CrossRefPubMed

74.

Goldman AL, Bhasin S, Wu FCW, Krishna M, Matsumoto AM, Jasuja R (2017) A reappraisal of Testosterone’s binding in circulation: physiological and clinical implications. Endocr Rev 38(4):302–324. https://doi.org/10.1210/er.2017-00025CrossRefPubMedPubMedCentral

75.

Keevil BG, Adaway J (2019) Assessment of free testosterone concentration. J Steroid Biochem Mol Biol 190:207–211. https://doi.org/10.1016/j.jsbmb.2019.04.008CrossRefPubMed

76.

Bergmann M, Behre HM, Nieschlag E (1994) Serum FSH and testicular morphology in male infertility. Clin Endocrinol (Oxf) 40(1):133–136. https://doi.org/10.1111/j.1365-2265.1994.tb02455.xCrossRef

77.

von Eckardstein S, Simoni M, Bergmann M, Weinbauer GF, Gassner P, Schepers AG et al (1999) Serum inhibin B in combination with serum follicle-stimulating hormone (FSH) is a more sensitive marker than serum FSH alone for impaired spermatogenesis in men, but cannot predict the presence of sperm in testicular tissue samples. J Clin Endocrinol Metab 84(7):2496–2501. https://doi.org/10.1210/jcem.84.7.5855CrossRef

78.

Kumanov P, Nandipati K, Tomova A, Agarwal A (2006) Inhibin B is a better marker of spermatogenesis than other hormones in the evaluation of male factor infertility. Fertil Steril 86(2):332–338. https://doi.org/10.1016/j.fertnstert.2006.01.022CrossRefPubMed

79.

Barbotin AL, Ballot C, Sigala J, Ramdane N, Duhamel A, Marcelli F et al (2015) The serum inhibin B concentration and reference ranges in normozoospermia. Eur J Endocrinol 172(6):669–676. https://doi.org/10.1530/EJE-14-0932CrossRefPubMed

80.

Andersson AM, Jørgensen N, Frydelund-Larsen L, Rajpert-De Meyts E, Skakkebaek NE (2004) Impaired Leydig cell function in infertile men: a study of 357 idiopathic infertile men and 318 proven fertile controls. J Clin Endocrinol Metab 89(7):3161–3167. https://doi.org/10.1210/jc.2003-031786CrossRefPubMed

81.

Ferlin A, Vinanzi C, Selice R, Garolla A, Frigo AC, Foresta C (2011) Toward a pharmacogenetic approach to male infertility: polymorphism of follicle-stimulating hormone beta-subunit promoter. Fertil Steril 96(6):1344–9.e2. https://doi.org/10.1016/j.fertnstert.2011.09.034CrossRefPubMed

82.

Lotti F, Maggi M (2015) Ultrasound of the male genital tract in relation to male reproductive health. Hum Reprod Update 21(1):56–83. https://doi.org/10.1093/humupd/dmu042CrossRefPubMed

83.

Dogra VS, Gottlieb RH, Oka M, Rubens DJ (2003) Sonography of the scrotum. Radiology 227(1):18–36. https://doi.org/10.1148/radiol.2271001744CrossRefPubMed

84.

Goede J, van der Voort-Doedens LM, Sijstermans K, Hack WW (2011) The volume of retractile testes. J Urol 186(5):2050–2054. https://doi.org/10.1016/j.juro.2011.07.020CrossRefPubMed

85.

Isidori AM, Giannetta E, Lenzi A (2008) Male hypogonadism. Pituitary 11(2):171–180. https://doi.org/10.1007/s11102-008-0111-9CrossRefPubMed

86.

Lotti F, Frizza F, Balercia G, Barbonetti A, Behre HM, Calogero AE et al (2021) The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Scrotal ultrasound reference ranges and associations with clinical, seminal, and biochemical characteristics. Andrology 9(2):559–576. https://doi.org/10.1111/andr.12951CrossRefPubMed

87.

Jørgensen N, Joensen UN, Toppari J, Punab M, Erenpreiss J, Zilaitiene B et al (2016) Compensated reduction in Leydig cell function is associated with lower semen quality variables: a study of 8182 European young men. Hum Reprod 31(5):947–957. https://doi.org/10.1093/humrep/dew021CrossRefPubMed

88.

Ventimiglia E, Capogrosso P, Boeri L, Serino A, Colicchia M, Ippolito S et al (2015) Infertility as a proxy of general male health: results of a cross-sectional survey. Fertil Steril 104(1):48–55. https://doi.org/10.1016/j.fertnstert.2015.04.020CrossRefPubMed

89.

Ventimiglia E, Capogrosso P, Colicchia M, Boeri L, Serino A, Castagna G et al (2016) Metabolic syndrome in white European men presenting for primary couple’s infertility: investigation of the clinical and reproductive burden. Andrology 4(5):944–951. https://doi.org/10.1111/andr.12232CrossRefPubMed

90.

Pozza C, Kanakis G, Carlomagno F, Lemma RPofi A, Tenuta M et al (2020) Testicular ultrasound score: a new proposal for a scoring system to predict testicular function. Andrology 8(5):1051–1063. https://doi.org/10.1111/andr.12822CrossRefPubMedPubMedCentral

91.

Isidori AM, Pozza C, Gianfrilli D, Giannetta E, Lemma RPofi A et al (2014) Differential diagnosis of nonpalpable testicular lesions: qualitative and quantitative contrast-enhanced US of benign and malignant testicular tumors. Radiology 273(2):606–618. https://doi.org/10.1148/radiol.14132718CrossRefPubMed

92.

Pozza C, Gianfrilli D, Fattorini G, Giannetta E, Barbagallo F, Nicolai E et al (2016) Diagnostic value of qualitative and strain ratio elastography in the differential diagnosis of non-palpable testicular lesions. Andrology 4(6):1193–1203. https://doi.org/10.1111/andr.12260CrossRefPubMedPubMedCentral

93.

Lotti F, Corona G, Castellini G, Maseroli E, Fino MG, Cozzolino M et al (2016) Semen quality impairment is associated with sexual dysfunction according to its severity. Hum Reprod 31(12):2668–2680. https://doi.org/10.1093/humrep/dew246CrossRefPubMed

94.

Lotti F, Bertolotto M, Maggi M (2021) Historical trends for the standards in scrotal ultrasonography: what was, what is and what will be normal. Andrology 9(5):1331–1355. https://doi.org/10.1111/andr.13062CrossRefPubMed

95.

Bieniek JM, Juvet T, Margolis M, Grober ED, Lo KC, Jarvi KA (2018) Prevalence and management of incidental small testicular masses discovered on ultrasonographic evaluation of male infertility. J Urol 199(2):481–486. https://doi.org/10.1016/j.juro.2017.08.004CrossRefPubMed

96.

Barbonetti A, Martorella A, Minaldi E, D’Andrea S, Bardhi D, Castellini C et al (2019) Testicular cancer in infertile men with and without testicular microlithiasis: a systematic review and meta-analysis of case-control studies. Front Endocrinol (Lausanne) 10:164. https://doi.org/10.3389/fendo.2019.00164CrossRef

97.

Singh R, Hamada AJ, Bukavina L, Agarwal A (2012) Physical deformities relevant to male infertility. Nat Rev Urol 9(3):156–174. https://doi.org/10.1038/nrurol.2012.11CrossRefPubMed

98.

Lotti F, Corona G, Cocci A, Cipriani S, Baldi E, Degl’Innocenti S et al (2018) The prevalence of midline prostatic cysts and the relationship between cyst size and semen parameters among infertile and fertile men. Hum Reprod 33(11):2023–2034. https://doi.org/10.1093/humrep/dey298CrossRefPubMed

99.

Di Trapani D, Pavone C, Serretta V, Cavallo N, Costa G, Pavone-Macaluso M (1988) Chronic prostatitis and prostatodynia: ultrasonographic alterations of the prostate, bladder neck, seminal vesicles and periprostatic venous plexus. Eur Urol 15(3–4):230–234. https://doi.org/10.1159/000473440CrossRefPubMed

100.

Doble A, Carter SS (1989) Ultrasonographic findings in prostatitis. Urol Clin N Am 16(4):763–772CrossRef

101.

Lotti F, Corona G, Mancini M, Filimberti E, Degli Innocenti S, Colpi GM et al (2011) Ultrasonographic and clinical correlates of seminal plasma interleukin-8 levels in patients attending an andrology clinic for infertility. Int J Androl 34(6 Pt 1):600–613. https://doi.org/10.1111/j.1365-2605.2010.01121.xCrossRefPubMed

102.

Lotti F, Maggi M (2013) Interleukin 8 and the male genital tract. J Reprod Immunol 100(1):54–65. https://doi.org/10.1016/j.jri.2013.02.004CrossRefPubMed

103.

La Vignera S, Calogero AE, Arancio A, Castiglione R, De Grande G, Vicari E (2008) Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia. Asian J Androl 10(5):731–740. https://doi.org/10.1111/j.1745-7262.2008.00425.xCrossRefPubMed

104.

Vicari E (1999) Seminal leukocyte concentration and related specific reactive oxygen species production in patients with male accessory gland infections. Hum Reprod 14(8):2025–2030. https://doi.org/10.1093/humrep/14.8.2025CrossRefPubMed

105.

La Vignera S, Condorelli RA, Di Mauro M, D’Agata R, Vicari E, Calogero AE (2011) Seminal vesicles and diabetic neuropathy: ultrasound evaluation. J Androl 32(5):478–483. https://doi.org/10.2164/jandrol.110.011676CrossRefPubMed

106.

La Vignera S, Vicari E, Condorelli R, D’Agata R, Calogero AE (2011) Hypertrophic-congestive and fibro-sclerotic ultrasound variants of male accessory gland infection have different sperm output. J Endocrinol Invest 34(10):e330–e335. https://doi.org/10.1007/BF03346729CrossRefPubMed

107.

La Vignera S, Vicari E, Condorelli RA, D’Agata R, Calogero AE (2011) Male accessory gland infection and sperm parameters (review). Int J Androl 34(5 Pt 2):e330–e347. https://doi.org/10.1111/j.1365-2605.2011.01200.xCrossRefPubMed

108.

La Vignera S, Condorelli RA, Cannarella R, Giacone F, Mongioi’ L, Scalia G et al (2019) High rate of detection of ultrasound signs of prostatitis in patients with HPV-DNA persistence on semen: role of ultrasound in HPV-related male accessory gland infection. J Endocrinol Invest 42(12):1459–1465. https://doi.org/10.1007/s40618-019-01069-8CrossRefPubMed

109.

Oates R (2012) Evaluation of the azoospermic male. Asian J Androl 14(1):82–87. https://doi.org/10.1038/aja.2011.60CrossRefPubMed

110.

Bettella A, Ferlin A, Menegazzo M, Ferigo M, Tavolini IM, Bassi PF et al (2005) Testicular fine needle aspiration as a diagnostic tool in non-obstructive azoospermia. Asian J Androl 7(3):289–294. https://doi.org/10.1111/j.1745-7262.2005.00043.xCrossRefPubMed

111.

Barbonetti A, Calogero AE, Balercia G, Garolla A, Krausz C, La Vignera S et al (2018) The use of follicle stimulating hormone (FSH) for the treatment of the infertile man: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS). J Endocrinol Invest 41(9):1107–1122. https://doi.org/10.1007/s40618-018-0843-yCrossRefPubMed

112.

Foresta C, Bettella A, Merico M, Garolla A, Plebani M, Ferlin A et al (2000) FSH in the treatment of oligozoospermia. Mol Cell Endocrinol 161(1–2):89–97. https://doi.org/10.1016/s0303-7207(99)00228-2CrossRefPubMed

113.

Foresta C, Selice R, Ferlin A, Garolla A (2009) Recombinant FSH in the treatment of oligozoospermia. Expert Opin Biol Ther 9(5):659–666. https://doi.org/10.1517/14712590902932673CrossRefPubMed

114.

Esteves SC (2016) Novel concepts in male factor infertility: clinical and laboratory perspectives. J Assist Reprod Genet 33(10):1319–1335. https://doi.org/10.1007/s10815-016-0763-8CrossRefPubMedPubMedCentral

115.

Krausz C, Riera-Escamilla A (2018) Genetics of male infertility. Nat Rev Urol 15(6):369–384. https://doi.org/10.1038/s41585-018-0003-3CrossRefPubMed

116.

Krausz C, Hoefsloot L, Simoni M, Tüttelmann F, Andrology EAo, Network EMGQ (2014) EAA/EMQN best practice guidelines for molecular diagnosis of Y-chromosomal microdeletions: state-of-the-art 2013. Andrology 2(1):5–19. https://doi.org/10.1111/j.2047-2927.2013.00173.xCrossRefPubMed

117.

Bieth E, Hamdi SM, Mieusset R (2021) Genetics of the congenital absence of the vas deferens. Hum Genet 140(1):59–76. https://doi.org/10.1007/s00439-020-02122-wCrossRefPubMed

118.

Ferlin A, Dipresa S, Delbarba A, Maffezzoni F, Porcelli T, Cappelli C et al (2019) Contemporary genetics-based diagnostics of male infertility. Expert Rev Mol Diagn 19(7):623–633. https://doi.org/10.1080/14737159.2019.1633917CrossRefPubMed

119.

Krausz C, Riera-Escamilla A (2019) Monogenic forms of male infertility. Exp Suppl 111:341–366. https://doi.org/10.1007/978-3-030-25905-1_16CrossRefPubMed

120.

Zuccarello D, Ferlin A, Vinanzi C, Prana E, Garolla A, Callewaert L et al (2008) Detailed functional studies on androgen receptor mild mutations demonstrate their association with male infertility. Clin Endocrinol (Oxf) 68(4):580–588. https://doi.org/10.1111/j.1365-2265.2007.03069.xCrossRef

121.

Krausz C, Riera-Escamilla A, Moreno-Mendoza D, Holleman K, Cioppi F, Algaba F et al (2020) Genetic dissection of spermatogenic arrest through exome analysis: clinical implications for the management of azoospermic men. Genet Med 22(12):1956–1966. https://doi.org/10.1038/s41436-020-0907-1CrossRefPubMedPubMedCentral

122.

Jensen TK, Jacobsen R, Christensen K, Nielsen NC, Bostofte E (2009) Good semen quality and life expectancy: a cohort study of 43,277 men. Am J Epidemiol 170(5):559–565. https://doi.org/10.1093/aje/kwp168CrossRefPubMed

123.

Salonia A, Matloob R, Gallina A, Abdollah F, Saccà A, Briganti A et al (2009) Are infertile men less healthy than fertile men? Results of a prospective case-control survey. Eur Urol 56(6):1025–1031. https://doi.org/10.1016/j.eururo.2009.03.001CrossRefPubMed

124.

Eisenberg ML, Li S, Behr B, Cullen MR, Galusha D, Lamb DJ et al (2014) Semen quality, infertility and mortality in the USA. Hum Reprod 29(7):1567–1574. https://doi.org/10.1093/humrep/deu106CrossRefPubMedPubMedCentral

125.

Eisenberg ML, Li S, Cullen MR, Baker LC (2016) Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data. Fertil Steril 105(3):629–636. https://doi.org/10.1016/j.fertnstert.2015.11.011CrossRefPubMed

126.

Latif T, Kold Jensen T, Mehlsen J, Holmboe SA, Brinth L, Pors K et al (2017) Semen quality as a predictor of subsequent morbidity: a Danish Cohort Study of 4,712 men with long-term follow-up. Am J Epidemiol 186(8):910–917. https://doi.org/10.1093/aje/kwx067CrossRefPubMed

127.

Bobjer J, Bogefors K, Isaksson S, Leijonhufvud I, Åkesson K, Giwercman YL et al (2016) High prevalence of hypogonadism and associated impaired metabolic and bone mineral status in subfertile men. Clin Endocrinol (Oxf) 85(2):189–195. https://doi.org/10.1111/cen.13038CrossRef

128.

Del Giudice F, Kasman AM, Ferro M, Sciarra A, De Berardinis E, Belladelli F et al (2020) Clinical correlation among male infertility and overall male health: a systematic review of the literature. Investig Clin Urol 61(4):355–371. https://doi.org/10.4111/icu.2020.61.4.355CrossRefPubMedPubMedCentral

129.

Ricci E, Al Beitawi S, Cipriani S, Candiani M, Chiaffarino F, Viganò P et al (2017) Semen quality and alcohol intake: a systematic review and meta-analysis. Reprod Biomed Online 34(1):38–47. https://doi.org/10.1016/j.rbmo.2016.09.012CrossRefPubMed

130.

La Vignera S, Condorelli RA, Balercia G, Vicari E, Calogero AE (2013) Does alcohol have any effect on male reproductive function? A review of literature. Asian J Androl 15(2):221–225. https://doi.org/10.1038/aja.2012.118CrossRefPubMed

131.

Rastrelli G, Lotti F, Reisman Y, Sforza A, Maggi M, Corona G (2019) Metabolically healthy and unhealthy obesity in erectile dysfunction and male infertility. Expert Rev Endocrinol Metab 14(5):321–334. https://doi.org/10.1080/17446651.2019.1657827CrossRefPubMed

132.

Jensen TK, Andersson AM, Jørgensen N, Andersen AG, Carlsen E, Petersen JH et al (2004) Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. Fertil Steril 82(4):863–870. https://doi.org/10.1016/j.fertnstert.2004.03.056CrossRefPubMed

133.

Chavarro JE, Toth TL, Wright DL, Meeker JD, Hauser R (2010) Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic. Fertil Steril 93(7):2222–2231. https://doi.org/10.1016/j.fertnstert.2009.01.100CrossRefPubMed

134.

Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A et al (2006) Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol 50(3):595–604. https://doi.org/10.1016/j.eururo.2006.02.053 (discussion)CrossRefPubMed

135.

Håkonsen LB, Thulstrup AM, Aggerholm AS, Olsen J, Bonde JP, Andersen CY et al (2011) Does weight loss improve semen quality and reproductive hormones? Results from a cohort of severely obese men. Reprod Health 8:24. https://doi.org/10.1186/1742-4755-8-24CrossRefPubMedPubMedCentral

136.

Redman LM (2006) Physical activity and its effects on reproduction. Reprod Biomed Online 12(5):579–586. https://doi.org/10.1016/s1472-6483(10)61183-2CrossRefPubMed

137.

Sharma R, Harlev A, Agarwal A, Esteves SC (2016) Cigarette smoking and semen quality: a new meta-analysis examining the effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. Eur Urol 70(4):635–645. https://doi.org/10.1016/j.eururo.2016.04.010CrossRefPubMed

138.

Calogero AE, Bagdy G, D’Agata R (1998) Mechanisms of stress on reproduction. Evidence for a complex intra-hypothalamic circuit. Ann N Y Acad Sci 851:364–370. https://doi.org/10.1111/j.1749-6632.1998.tb09010.xCrossRefPubMed

139.

Durairajanayagam D, Agarwal A, Ong C (2015) Causes, effects and molecular mechanisms of testicular heat stress. Reprod Biomed Online 30(1):14–27. https://doi.org/10.1016/j.rbmo.2014.09.018CrossRefPubMed

140.

Aitken RJ, Baker MA (2006) Oxidative stress, sperm survival and fertility control. Mol Cell Endocrinol 250(1–2):66–69. https://doi.org/10.1016/j.mce.2005.12.026CrossRefPubMed

141.

Li Y, Lin H, Cao J (2011) Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses. Fertil Steril 95(1):116–123. https://doi.org/10.1016/j.fertnstert.2010.06.031CrossRefPubMed

142.

Gollenberg AL, Liu F, Brazil C, Drobnis EZ, Guzick D, Overstreet JW et al (2010) Semen quality in fertile men in relation to psychosocial stress. Fertil Steril 93(4):1104–1111. https://doi.org/10.1016/j.fertnstert.2008.12.018CrossRefPubMed

143.

Holmes D (2013) Endocrine disruptors cause toxic fallout. Lancet Diabetes Endocrinol 1(2):93–94. https://doi.org/10.1016/S2213-8587(13)70057-3CrossRefPubMed

144.

Mínguez-Alarcón L, Chavarro JE, Gaskins AJ (2018) Caffeine, alcohol, smoking, and reproductive outcomes among couples undergoing assisted reproductive technology treatments. Fertil Steril 110(4):587–592. https://doi.org/10.1016/j.fertnstert.2018.05.026CrossRefPubMed

145.

Smits RM, Mackenzie-Proctor R, Yazdani A, Stankiewicz MT, Jordan V, Showell MG (2019) Antioxidants for male subfertility. Cochrane Database Syst Rev 3:CD007411. https://doi.org/10.1002/14651858.CD007411.pub4CrossRefPubMed

146.

Buhling K, Schumacher A, Eulenburg CZ, Laakmann E (2019) Influence of oral vitamin and mineral supplementation on male infertility: a meta-analysis and systematic review. Reprod Biomed Online 39(2):269–279. https://doi.org/10.1016/j.rbmo.2019.03.099CrossRefPubMed

147.

Salas-Huetos A, Rosique-Esteban N, Becerra-Tomás N, Vizmanos B, Bulló M, Salas-Salvadó J (2018) The effect of nutrients and dietary supplements on sperm quality parameters: a systematic review and meta-analysis of randomized clinical trials. Adv Nutr 9(6):833–848. https://doi.org/10.1093/advances/nmy057CrossRefPubMedPubMedCentral

148.

Hosseini B, Nourmohamadi M, Hajipour S, Taghizadeh M, Asemi Z, Keshavarz SA et al (2019) The effect of omega-3 fatty acids, EPA, and/or DHA on male infertility: a systematic review and meta-analysis. J Diet Suppl 16(2):245–256. https://doi.org/10.1080/19390211.2018.1431753CrossRefPubMed

149.

Lafuente R, González-Comadrán M, Solà I, López G, Brassesco M, Carreras R et al (2013) Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet 30(9):1147–1156. https://doi.org/10.1007/s10815-013-0047-5CrossRefPubMedPubMedCentral

150.

Omar MI, Pal RP, Kelly BD, Bruins HM, Yuan Y, Diemer T et al (2019) Benefits of empiric nutritional and medical therapy for semen parameters and pregnancy and live birth rates in couples with idiopathic infertility: a systematic review and meta-analysis. Eur Urol 75(4):615–625. https://doi.org/10.1016/j.eururo.2018.12.022CrossRefPubMed

151.

Irani M, Amirian M, Sadeghi R, Lez JL, Latifnejad RR (2017) The effect of folate and folate plus zinc supplementation on endocrine parameters and sperm characteristics in sub-fertile men: a systematic review and meta-analysis. Urol J 14(5):4069–4078PubMed

152.

Steiner AZ, Hansen KR, Barnhart KT, Cedars MI, Legro RS, Diamond MP et al (2020) The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. Fertil Steril 113(3):552–60.e3. https://doi.org/10.1016/j.fertnstert.2019.11.008CrossRefPubMedPubMedCentral

153.

Schisterman EF, Sjaarda LA, Clemons T, Carrell DT, Perkins NJ, Johnstone E et al (2020) Effect of folic acid and zinc supplementation in men on semen quality and live birth among couples undergoing infertility treatment: a randomized clinical trial. JAMA 323(1):35–48. https://doi.org/10.1001/jama.2019.18714CrossRefPubMedPubMedCentral

154.

Chen Q, Zhao JY, Xue X, Zhu GX (2019) The association between sperm DNA fragmentation and reproductive outcomes following intrauterine insemination, a meta analysis. Reprod Toxicol 86:50–55. https://doi.org/10.1016/j.reprotox.2019.03.004CrossRefPubMed

155.

Deng C, Li T, Xie Y, Guo Y, Yang QY, Liang X et al (2019) Sperm DNA fragmentation index influences assisted reproductive technology outcome: a systematic review and meta-analysis combined with a retrospective cohort study. Andrologia 51(6):e13263. https://doi.org/10.1111/and.13263CrossRefPubMed

156.

McQueen DB, Zhang J, Robins JC (2019) Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril 112(1):54-60.e3. https://doi.org/10.1016/j.fertnstert.2019.03.003CrossRefPubMed

157.

Calogero AE, Aversa A, La Vignera S, Corona G, Ferlin A (2017) The use of nutraceuticals in male sexual and reproductive disturbances: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS). J Endocrinol Invest 40(12):1389–1397. https://doi.org/10.1007/s40618-017-0699-6CrossRefPubMed

158.

Calogero AE, Duca Y, Condorelli RA, La Vignera S (2017) Male accessory gland inflammation, infertility, and sexual dysfunctions: a practical approach to diagnosis and therapy. Andrology 5(6):1064–1072. https://doi.org/10.1111/andr.12427CrossRefPubMed

159.

Gallegos G, Ramos B, Santiso R, Goyanes V, Gosálvez J, Fernández JL (2008) Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma. Fertil Steril 90(2):328–334. https://doi.org/10.1016/j.fertnstert.2007.06.035CrossRefPubMed

160.

Cai T, Wagenlehner FM, Mazzoli S, Meacci F, Mondaini N, Nesi G et al (2012) Semen quality in patients with Chlamydia trachomatis genital infection treated concurrently with prulifloxacin and a phytotherapeutic agent. J Androl 33(4):615–623. https://doi.org/10.2164/jandrol.111.013961CrossRefPubMed

161.

Ahmadi MH, Mirsalehian A, Sadighi Gilani MA, Bahador A, Talebi M (2017) Asymptomatic infection with Mycoplasma hominis negatively affects semen parameters and leads to male infertility as confirmed by improved semen parameters after antibiotic treatment. Urology 100:97–102. https://doi.org/10.1016/j.urology.2016.11.018CrossRefPubMed

162.

Mićić S (1988) Kallikrein and antibiotics in the treatment of infertile men with genital tract infections. Andrologia 20(1):55–59CrossRefPubMed

163.

Comhaire FH, Rowe PJ, Farley TM (1986) The effect of doxycycline in infertile couples with male accessory gland infection: a double blind prospective study. Int J Androl 9(2):91–98. https://doi.org/10.1111/j.1365-2605.1986.tb00871.xCrossRefPubMed

164.

Vicari E (2000) Effectiveness and limits of antimicrobial treatment on seminal leukocyte concentration and related reactive oxygen species production in patients with male accessory gland infection. Hum Reprod 15(12):2536–2544. https://doi.org/10.1093/humrep/15.12.2536CrossRefPubMed

165.

Merino G, Carranza-Lira S (1995) Infection and male infertility: effect of different antibiotic regimens on semen quality. Arch Androl 35(3):209–212. https://doi.org/10.3109/01485019508987872CrossRefPubMed

166.

Harrison RF, de Louvois J, Blades M, Hurley R (1975) Doxycycline treatment and human infertility. Lancet 1(7907):605–607. https://doi.org/10.1016/s0140-6736(75)91885-1CrossRefPubMed

167.

Vicari E, La Vignera S, Calogero AE (2002) Antioxidant treatment with carnitines is effective in infertile patients with prostatovesiculoepididymitis and elevated seminal leukocyte concentrations after treatment with nonsteroidal anti-inflammatory compounds. Fertil Steril 78(6):1203–1208. https://doi.org/10.1016/s0015-0282(02)04350-9CrossRefPubMed

168.

Brunner RJ, Demeter JH, Sindhwani P (2019) Review of guidelines for the evaluation and treatment of leukocytospermia in male infertility. World J Mens Health 37(2):128–137. https://doi.org/10.5534/wjmh.180078CrossRefPubMed

169.

Santi D, Crépieux P, Reiter E, Spaggiari G, Brigante G, Casarini L et al (2020) Follicle-stimulating hormone (FSH) action on spermatogenesis: a focus on physiological and therapeutic roles. J Clin Med. https://doi.org/10.3390/jcm9041014CrossRefPubMedPubMedCentral

170.

Simoni M, Brigante G, Rochira V, Santi D, Casarini L (2020) Prospects for FSH treatment of male infertility. J Clin Endocrinol Metab. https://doi.org/10.1210/clinem/dgaa243CrossRefPubMed

171.

Santi D, Granata AR, Simoni M (2015) FSH treatment of male idiopathic infertility improves pregnancy rate: a meta-analysis. Endocr Connect 4(3):R46-58. https://doi.org/10.1530/EC-15-0050CrossRefPubMedPubMedCentral

172.

Attia AM, Abou-Setta AM, Al-Inany HG (2013) Gonadotrophins for idiopathic male factor subfertility. Cochrane Database Syst Rev 8:CD005071. https://doi.org/10.1002/14651858.CD005071.pub4CrossRef

173.

Cannarella R, La Vignera S, Condorelli RA, Mongioì LM, Calogero AE (2020) FSH dosage effect on conventional sperm parameters: a meta-analysis of randomized controlled studies. Asian J Androl 22(3):309–316. https://doi.org/10.4103/aja.aja_42_19CrossRefPubMed

174.

De Rocco PM, Foresta C, Rago R, Dal Lago A, Balercia G, Calogero AE et al (2020) Use of biosimilar follicle-stimulating hormone in asthenozoospermic infertile patients: a multicentric study. J Clin Med. https://doi.org/10.3390/jcm9051478CrossRefPubMedPubMedCentral

175.

Simoni M, Santi D, Negri L, Hoffmann I, Muratori M, Baldi E et al (2016) Treatment with human, recombinant FSH improves sperm DNA fragmentation in idiopathic infertile men depending on the FSH receptor polymorphism p.N680S: a pharmacogenetic study. Hum Reprod 31(9):1960–1969. https://doi.org/10.1093/humrep/dew167CrossRefPubMed

176.

Chua ME, Escusa KG, Luna S, Tapia LC, Dofitas B, Morales M (2013) Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis. Andrology 1(5):749–757. https://doi.org/10.1111/j.2047-2927.2013.00107.xCrossRefPubMed

177.

Cannarella R, Condorelli RA, Mongioì LM, Barbagallo F, Calogero AE, La Vignera S (2019) Effects of the selective estrogen receptor modulators for the treatment of male infertility: a systematic review and meta-analysis. Expert Opin Pharmacother 20(12):1517–1525. https://doi.org/10.1080/14656566.2019.1615057CrossRefPubMed

178.

Shahid MN, Khan TM, Neoh CF, Lean QY, Bukhsh A, Karuppannan M (2021) Effectiveness of pharmacological intervention among men with infertility: a systematic review and network meta-analysis. Front Pharmacol 12:638628. https://doi.org/10.3389/fphar.2021.638628CrossRefPubMedPubMedCentral

179.

Del Giudice F, Busetto GM, De Berardinis E, Sperduti I, Ferro M, Maggi M et al (2020) A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility. Asian J Androl 22(4):360–367. https://doi.org/10.4103/aja.aja_101_19CrossRefPubMed

180.

Yang C, Li P, Li Z (2021) Clinical application of aromatase inhibitors to treat male infertility. Hum Reprod Update. https://doi.org/10.1093/humupd/dmab036CrossRefPubMed

181.

Alsaikhan B, Alrabeeah K, Delouya G, Zini A (2016) Epidemiology of varicocele. Asian J Androl 18(2):179–181. https://doi.org/10.4103/1008-682X.172640CrossRefPubMedPubMedCentral

182.

Freeman S, Bertolotto M, Richenberg J, Belfield J, Dogra V, Huang DY et al (2020) Ultrasound evaluation of varicoceles: guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection, classification, and grading. Eur Radiol 30(1):11–25. https://doi.org/10.1007/s00330-019-06280-yCrossRefPubMed

183.

Bertolotto M, Freeman S, Richenberg J, Belfield J, Dogra V, Huang DY et al (2020) Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations. J Ultrasound 23(4):487–507. https://doi.org/10.1007/s40477-020-00509-zCrossRefPubMedPubMedCentral

184.

Redmon JB, Carey P, Pryor JL (2002) Varicocele–the most common cause of male factor infertility? Hum Reprod Update 8(1):53–58. https://doi.org/10.1093/humupd/8.1.53CrossRefPubMed

185.

Fallara G, Cazzaniga W, Boeri L, Capogrosso P, Candela L, Pozzi E et al (2021) Male factor infertility trends throughout the last 10 years: report from a tertiary-referral academic andrology centre. Andrology 9(2):610–617. https://doi.org/10.1111/andr.12947CrossRefPubMed

186.

Esteves SC, Santi D, Simoni M (2020) An update on clinical and surgical interventions to reduce sperm DNA fragmentation in infertile men. Andrology 8(1):53–81. https://doi.org/10.1111/andr.12724CrossRefPubMed

187.

Persad E, O’Loughlin CA, Kaur S, Wagner G, Matyas N, Hassler-Di Fratta MR et al (2021) Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev 4:CD000479. https://doi.org/10.1002/14651858.CD000479.pub6CrossRefPubMed

188.

La Vignera S, Condorelli R, Vicari E, D’Agata R, Calogero AE (2012) Effects of varicocelectomy on sperm DNA fragmentation, mitochondrial function, chromatin condensation, and apoptosis. J Androl 33(3):389–396. https://doi.org/10.2164/jandrol.111.013433CrossRefPubMed

189.

Sansone A, Fegatelli DA, Pozza C, Fattorini G, Lauretta R, Minnetti M et al (2019) Effects of percutaneous varicocele repair on testicular volume: results from a 12-month follow-up. Asian J Androl 21(4):408–412. https://doi.org/10.4103/aja.aja_102_18CrossRefPubMed

190.

Kohn TP, Ohlander SJ, Jacob JS, Griffin TM, Lipshultz LI, Pastuszak AW (2018) The effect of subclinical varicocele on pregnancy rates and semen parameters: a systematic review and meta-analysis. Curr Urol Rep 19(7):53. https://doi.org/10.1007/s11934-018-0798-8CrossRefPubMed

191.

Kirby EW, Wiener LE, Rajanahally S, Crowell K, Coward RM (2016) Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril 106(6):1338–1343. https://doi.org/10.1016/j.fertnstert.2016.07.1093CrossRefPubMed

192.

Corona G, Minhas S, Giwercman A, Bettocchi C, Dinkelman-Smit M, Dohle G et al (2019) Sperm recovery and ICSI outcomes in men with non-obstructive azoospermia: a systematic review and meta-analysis. Hum Reprod Update 25(6):733–757. https://doi.org/10.1093/humupd/dmz028CrossRefPubMed

193.

Bernie AM, Mata DA, Ramasamy R, Schlegel PN (2015) Comparison of microdissection testicular sperm extraction, conventional testicular sperm extraction, and testicular sperm aspiration for nonobstructive azoospermia: a systematic review and meta-analysis. Fertil Steril 104(5):1099-103.e1–3. https://doi.org/10.1016/j.fertnstert.2015.07.1136CrossRefPubMed

194.

Deruyver Y, Vanderschueren D, Van der Aa F (2014) Outcome of microdissection TESE compared with conventional TESE in non-obstructive azoospermia: a systematic review. Andrology 2(1):20–24. https://doi.org/10.1111/j.2047-2927.2013.00148.xCrossRefPubMed

195.

Esteves SC, Lee W, Benjamin DJ, Seol B, Verza S, Agarwal A (2013) Reproductive potential of men with obstructive azoospermia undergoing percutaneous sperm retrieval and intracytoplasmic sperm injection according to the cause of obstruction. J Urol 189(1):232–237. https://doi.org/10.1016/j.juro.2012.08.084CrossRefPubMed

196.

Desai N, AbdelHafez F, Sabanegh E, Goldfarb J (2009) Paternal effect on genomic activation, clinical pregnancy and live birth rate after ICSI with cryopreserved epididymal versus testicular spermatozoa. Reprod Biol Endocrinol 7:142. https://doi.org/10.1186/1477-7827-7-142CrossRefPubMedPubMedCentral

197.

Nicopoullos JD, Gilling-Smith C, Almeida PA, Norman-Taylor J, Grace I, Ramsay JW (2004) Use of surgical sperm retrieval in azoospermic men: a meta-analysis. Fertil Steril 82(3):691–701. https://doi.org/10.1016/j.fertnstert.2004.02.116CrossRefPubMed

198.

Schlegel PN, Palermo GD, Alikani M, Adler A, Reing AM, Cohen J et al (1995) Micropuncture retrieval of epididymal sperm with in vitro fertilization: importance of in vitro micromanipulation techniques. Urology 46(2):238–241. https://doi.org/10.1016/s0090-4295(99)80199-xCrossRefPubMed

199.

Van Peperstraten A, Proctor ML, Johnson NP, Philipson G (2008) Techniques for surgical retrieval of sperm prior to intra-cytoplasmic sperm injection (ICSI) for azoospermia. Cochrane Database Syst Rev 2:CD002807. https://doi.org/10.1002/14651858.CD002807.pub3CrossRef

200.

Bachtell NE, Conaghan J, Turek PJ (1999) The relative viability of human spermatozoa from the vas deferens, epididymis and testis before and after cryopreservation. Hum Reprod 14(12):3048–3051. https://doi.org/10.1093/humrep/14.12.3048CrossRefPubMed

201.

Habermann H, Seo R, Cieslak J, Niederberger C, Prins GS, Ross L (2000) In vitro fertilization outcomes after intracytoplasmic sperm injection with fresh or frozen-thawed testicular spermatozoa. Fertil Steril 73(5):955–960. https://doi.org/10.1016/s0015-0282(00)00416-7CrossRefPubMed

202.

Cayan S, Lee D, Conaghan J, Givens CA, Ryan IP, Schriock ED et al (2001) A comparison of ICSI outcomes with fresh and cryopreserved epididymal spermatozoa from the same couples. Hum Reprod 16(3):495–499. https://doi.org/10.1093/humrep/16.3.495CrossRefPubMed

203.

Mazzilli R, Cimadomo D, Vaiarelli A, Capalbo A, Dovere L, Alviggi E et al (2017) Effect of the male factor on the clinical outcome of intracytoplasmic sperm injection combined with preimplantation aneuploidy testing: observational longitudinal cohort study of 1,219 consecutive cycles. Fertil Steril 108(6):961–72.e3. https://doi.org/10.1016/j.fertnstert.2017.08.033CrossRefPubMed

204.

Boomsma CM, Cohlen BJ, Farquhar C (2019) Semen preparation techniques for intrauterine insemination. Cochrane Database Syst Rev 10:CD004507. https://doi.org/10.1002/14651858.CD004507.pub4CrossRefPubMed

205.

Van der Zwalmen P, Bertin-Segal G, Geerts L, Debauche C, Schoysman R (1991) Sperm morphology and IVF pregnancy rate: comparison between Percoll gradient centrifugation and swim-up procedures. Hum Reprod 6(4):581–588. https://doi.org/10.1093/oxfordjournals.humrep.a137383CrossRefPubMed

206.

Englert Y, Van den Bergh M, Rodesch C, Bertrand E, Biramane J, Legreve A (1992) Comparative auto-controlled study between swim-up and Percoll preparation of fresh semen samples for in-vitro fertilization. Hum Reprod 7(3):399–402. https://doi.org/10.1093/oxfordjournals.humrep.a137657CrossRefPubMed

207.

Sapienza F, Verheyen G, Tournaye H, Janssens R, Pletincx I, Derde M et al (1993) An auto-controlled study in in-vitro fertilization reveals the benefit of Percoll centrifugation to swim-up in the preparation of poor-quality semen. Hum Reprod 8(11):1856–1862. https://doi.org/10.1093/oxfordjournals.humrep.a137949CrossRefPubMed

208.

Leonetti T, Causio F, Cagnazzo G (1995) Techniques of sperm selection and in vitro fertilization results. Acta Eur Fertil 26(1):31–34PubMed

209.

Hammadeh ME, Zavos PM, Rosenbaum P, Schmidt W (2001) Comparison between the quality and function of sperm after semen processing with two different methods. Asian J Androl 3(2):125–130PubMed

210.

Borges E, Setti AS, Vingris L, Figueira REC, Braga DP, Iaconelli A (2013) Intracytoplasmic morphologically selected sperm injection outcomes: the role of sperm preparation techniques. J Assist Reprod Genet 30(6):849–854. https://doi.org/10.1007/s10815-013-9989-xCrossRefPubMedPubMedCentral

211.

Kim EK, Kim EH, Kim EA, Lee KA, Shin JE, Kwon H (2015) Comparison of the effect of different media on the clinical outcomes of the density-gradient centrifugation/swim-up and swim-up methods. Clin Exp Reprod Med 42(1):22–29. https://doi.org/10.5653/cerm.2015.42.1.22CrossRefPubMedPubMedCentral

212.

Palini S, Stefani S, Primiterra M, Benedetti S, Barone S, Carli L et al (2017) Comparison of in vitro fertilization outcomes in ICSI cycles after human sperm preparation by density gradient centrifugation and direct micro swim-up without centrifugation. JBRA Assist Reprod 21(2):89–93. https://doi.org/10.5935/1518-0557.20170022CrossRefPubMedPubMedCentral

213.

coticchio.biogenesi@grupposandonato.it ESIGoEaASiRMEa (2017) The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators. Reprod Biomed Online 35(5):494–510. https://doi.org/10.1016/j.rbmo.2017.06.015CrossRef

214.

Teixeira DM, Hadyme Miyague A, Barbosa MA, Navarro PA, Raine-Fenning N, Nastri CO et al (2020) Regular (ICSI) versus ultra-high magnification (IMSI) sperm selection for assisted reproduction. Cochrane Database Syst Rev 2:CD010167. https://doi.org/10.1002/14651858.CD010167.pub3CrossRefPubMed

215.

Lepine S, McDowell S, Searle LM, Kroon B, Glujovsky D, Yazdani A (2019) Advanced sperm selection techniques for assisted reproduction. Cochrane Database Syst Rev 7:CD010461. https://doi.org/10.1002/14651858.CD010461.pub3CrossRefPubMed

216.

Samuel R, Feng H, Jafek A, Despain D, Jenkins T, Gale B (2018) Microfluidic-based sperm sorting & analysis for treatment of male infertility. Transl Androl Urol 7(Suppl 3):S336–S347. https://doi.org/10.21037/tau.2018.05.08CrossRefPubMedPubMedCentral

217.

Ibrahim E, Brackett NL, Lynne CM (2016) Advances in the management of infertility in men with spinal cord injury. Asian J Androl 18(3):382–390. https://doi.org/10.4103/1008-682X.178851CrossRefPubMedPubMedCentral

218.

Reignier A, Lammers J, Splingart C, Redhead D, Labat JJ, Mirallié S et al (2018) Sperm cryopreservation and assisted reproductive technology outcome in patients with spinal cord injury. Andrologia. https://doi.org/10.1111/and.12833CrossRefPubMed

219.

Koscinski I, Wittemer C, Lefebvre-Khalil V, Marcelli F, Defossez A, Rigot JM (2007) Optimal management of extreme oligozoospermia by an appropriate cryopreservation programme. Hum Reprod 22(10):2679–2684. https://doi.org/10.1093/humrep/dem190CrossRefPubMed

220.

Corona G, Pizzocaro A, Lanfranco F, Garolla A, Pelliccione F, Vignozzi L et al (2017) Sperm recovery and ICSI outcomes in Klinefelter syndrome: a systematic review and meta-analysis. Hum Reprod Update 23(3):265–275. https://doi.org/10.1093/humupd/dmx008CrossRefPubMed

221.

Tao Y, Sanger E, Saewu A, Leveille MC (2020) Human sperm vitrification: the state of the art. Reprod Biol Endocrinol 18(1):17. https://doi.org/10.1186/s12958-020-00580-5CrossRefPubMedPubMedCentral

222.

Gandini L, Sgrò P, Lombardo F, Paoli D, Culasso F, Toselli L et al (2006) Effect of chemo- or radiotherapy on sperm parameters of testicular cancer patients. Hum Reprod 21(11):2882–2889. https://doi.org/10.1093/humrep/del167CrossRefPubMed

223.

Paoli D, Rizzo F, Fiore G, Pallotti F, Pulsoni A, Annechini G et al (2016) Spermatogenesis in Hodgkin’s lymphoma patients: a retrospective study of semen quality before and after different chemotherapy regimens. Hum Reprod 31(2):263–272. https://doi.org/10.1093/humrep/dev310CrossRefPubMed

224.

Dohle GR (2010) Male infertility in cancer patients: review of the literature. Int J Urol 17(4):327–331. https://doi.org/10.1111/j.1442-2042.2010.02484.xCrossRefPubMed

225.

Kuczyński W, Dhont M, Grygoruk C, Grochowski D, Wołczyński S, Szamatowicz M (2001) The outcome of intracytoplasmic injection of fresh and cryopreserved ejaculated spermatozoa–a prospective randomized study. Hum Reprod 16(10):2109–2113. https://doi.org/10.1093/humrep/16.10.2109CrossRefPubMed

226.

Yu Z, Wei Z, Yang J, Wang T, Jiang H, Li H et al (2018) Comparison of intracytoplasmic sperm injection outcome with fresh versus frozen-thawed testicular sperm in men with nonobstructive azoospermia: a systematic review and meta-analysis. J Assist Reprod Genet 35(7):1247–1257. https://doi.org/10.1007/s10815-018-1206-5CrossRefPubMedPubMedCentral

227.

Ferrari S, Paffoni A, Filippi F, Busnelli A, Vegetti W, Somigliana E (2016) Sperm cryopreservation and reproductive outcome in male cancer patients: a systematic review. Reprod Biomed Online 33(1):29–38. https://doi.org/10.1016/j.rbmo.2016.04.002CrossRefPubMed

228.

Trottmann M, Becker AJ, Stadler T, Straub J, Soljanik I, Schlenker B et al (2007) Semen quality in men with malignant diseases before and after therapy and the role of cryopreservation. Eur Urol 52(2):355–367. https://doi.org/10.1016/j.eururo.2007.03.085CrossRefPubMed

229.

Di Bisceglie C, Bertagna A, Composto ER, Lanfranco F, Baldi M, Motta G et al (2013) Effects of oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders. Asian J Androl 15(3):425–429. https://doi.org/10.1038/aja.2012.171CrossRefPubMedPubMedCentral

230.

Bujan L, Walschaerts M, Moinard N, Hennebicq S, Saias J, Brugnon F et al (2013) Impact of chemotherapy and radiotherapy for testicular germ cell tumors on spermatogenesis and sperm DNA: a multicenter prospective study from the CECOS network. Fertil Steril 100(3):673–680. https://doi.org/10.1016/j.fertnstert.2013.05.018CrossRefPubMed

231.

Ghezzi M, Berretta M, Bottacin A, Palego P, Sartini B, Cosci I et al (2016) Impact of Bep or carboplatin chemotherapy on testicular function and sperm nucleus of subjects with testicular germ cell tumor. Front Pharmacol 7:122. https://doi.org/10.3389/fphar.2016.00122CrossRefPubMedPubMedCentral

232.

Paoli D, Pelloni M, Lenzi A, Lombardo F (2019) Cryopreservation of sperm: effects on chromatin and strategies to prevent them. Adv Exp Med Biol 1166:149–167. https://doi.org/10.1007/978-3-030-21664-1_9CrossRefPubMed

233.

Oktay K, Harvey BE, Partridge AH, Quinn GP, Reinecke J, Taylor HS et al (2018) Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol 36(19):1994–2001. https://doi.org/10.1200/JCO.2018.78.1914CrossRefPubMed

234.

Tiseo BC, Cocuzza M, Bonfa E, Srougi M, Silva CA (2016) Male fertility potential alteration in rheumatic diseases: a systematic review. Int Braz J Urol 42(1):11–21. https://doi.org/10.1590/S1677-5538.IBJU.2014.0595CrossRefPubMedPubMedCentral

235.

Banerjee A, Scarpa M, Pathak S, Burra P, Sturniolo GC, Russo FP et al (2019) Inflammatory bowel disease therapies adversely affect fertility in men—a systematic review and meta-analysis. Endocr Metab Immune Disord Drug Targets 19(7):959–974. https://doi.org/10.2174/1871530319666190313112110CrossRefPubMed

Titel: Management of male factor infertility: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS)
Endorsing Organization: Italian Society of Embryology, Reproduction, and Research (SIERR)
verfasst von: A. Ferlin
A. E. Calogero
C. Krausz
F. Lombardo
D. Paoli
R. Rago
C. Scarica
M. Simoni
C. Foresta
V. Rochira
E. Sbardella
S. Francavilla
G. Corona
Publikationsdatum: 01.05.2022
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 5/2022
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-022-01741-6

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