Male reproductive health evaluation involves andrological and sexological clinical problems but, on a wider scale, it also involves other public health issues, including lifestyle and metabolic factors. These factors, especially if combined with pre-existing andrological diseases, have been found to be significantly associated with semen parameters impairment and, thus, male infertility. A hypothesized trend of decline of male fertility has been debated in the last years and this aspect is strictly intertwined with the evolution of the incidence of male fertility disorders over the last decades. It should be stressed that all these factors harbour relevant repercussions for both individual reproductive health as well as broader socio-economic and demographic issues. Thus, the aim of this review is to perform a short and critical overview of the andrological issues affecting the reproductive outcomes of the infertile male as well as provide a comprehensive and critical overview of the male fertility decline issue.

Male infertility

Risk factors

Varicocele

Cryptorchidism

Fertility decline

Lifestyle

© 2025 The Authors. Published by Elsevier Ltd.