Etiological and Therapeutic Perspectives in Idiopathic Male Infertility

Idiopathic male infertility represents a pressing challenge in the field of reproductive medicine and andrology, currently impacting a significant proportion of couples worldwide. Although advances in diagnostic methods have been made, a considerable subset of men with altered semen parameters remains without a clear etiological explanation after thorough evaluation. Several hypotheses have emerged to explain declining semen quality observed over recent decades, focusing on factors such as oxidative stress, exposure to endocrine disruptors, obesity, changing lifestyles, environmental toxicants, hormonal imbalances - including hypogonadism and low testosterone levels, beyond isolated alterations in FSH - and emerging influences such as gut and seminal microbiota composition. Studies investigating these aspects, as well as the interplay of genetic and acquired factors, have yielded promising but often inconclusive or contradictory results. The limited clarity on mechanisms hinders definitive risk stratification and individualized management, emphasizing persistent knowledge gaps and the necessity for well-designed research to bridge them.This Research Topic aims to stimulate high-quality research focused on elucidating the underlying etiological factors contributing to idiopathic male infertility and to critically assess and optimize current and novel therapeutic options. A particular emphasis will be placed on clarifying mechanisms by which environmental, genetic, metabolic, endocrine, and microbial factors contribute to idiopathic male infertility, as well as exploring innovative treatments or repurposed therapies with the potential to improve clinical outcomes. Researchers are encouraged to address specific clinical, molecular, or therapeutic questions; test new hypotheses; and shed light on poorly understood contributory mechanisms.The range of this Research Topic encompasses mechanistic, translational, and clinical research relating to the origins and management of idiopathic male infertility, while excluding primary infertility with known etiologies or female-derived factors. To gather further insights into this complex condition, we welcome articles addressing, but not limited to, the following themes:- Influence of oxidative stress and environmental exposures on male reproductive health- Role of genetic and epigenetic variants in idiopathic infertility- Contribution of gut and seminal microbiota to sperm function and fertility- Evaluations of pharmacological and non-pharmacological therapeutic strategies- Impact of obesity, metabolic syndrome, and lifestyle modifications- Role of hypogonadism, low testosterone, and broader hormonal dysregulation (beyond FSH alterations) in idiopathic male infertility- Development and validation of new biomarkers for diagnosis and prognosis- Standardization and advancement in semen analysis methodologiesTopic editor Gianmaria Salvio has participated in a scientific board organized by Gedeon Richter. Topic editors: Alessandro Ciarloni, Gianmaria Salvio Source: https://www.frontiersin.org/research-topics/79801/etiological-and-therapeutic-perspectives-in-idiopathic-male-infertility