Probiotics as Microbiome Modulators in Male Infertility: Rethinking Dysbiosis Across the Gut-Testis Axis

Area of Science:

• Reproductive Biology
• Microbiome Research
• Male Infertility

Background:

• Male infertility affects couples significantly, with many cases being idiopathic.
• Gut, seminal, and urinary microbiome dysbiosis is linked to poor semen quality, inflammation, and oxidative stress.

Purpose of the Study:

• To review the gut-testis axis and the androbactome in male infertility.
• To explore mechanisms connecting microbial imbalance to sperm dysfunction.
• To evaluate the current evidence for probiotics/synbiotics in male infertility.

Main Methods:

• Structured literature search for narrative review.
• Synthesis of evidence on gut-testis axis and androbactome.
• Analysis of proposed mechanistic pathways and clinical trial data.

Main Results:

• Microbial imbalance may cause male infertility via immune activation, oxidative stress, endocrine/metabolic changes, and barrier disruption.
• Early trials suggest probiotics/synbiotics may improve semen parameters and reduce biomarkers in specific populations.
• Pregnancy and live-birth outcomes remain unproven; probiotics are adjuncts, not standalone therapies.

Conclusions:

• Personalized approaches with defined phenotypes and monitoring targets are necessary.
• Probiotics should be considered adjunctive, not primary, therapy for male infertility.
• Further rigorous studies and randomized trials with clinical endpoints are essential for routine implementation.