Ces Urol 2025, 29(2):86-93 | DOI: 10.48095/cccu2025014

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

Marek Broul^1–3, Aneta Hujová³, Michaela Liegertová⁴

¹ Sexuologické oddělení, Krajská zdravotní, a.s. – Masarykova nemocnice v Ústí nad Labem, o.z

² Urologické oddělení, Krajská zdravotní, a. s. – Nemocnice Litoměřice, o.z.

³ Fakulta zdravotnických studií UJEP v Ústí nad Labem

⁴ Přírodovědecká fakulta UJEP v Ústí nad Labem

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 6^th 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

Received: May 4, 2025; Revised: May 19, 2025; Accepted: May 27, 2025; Published: June 24, 2025