Limited interventions to improve male fertility

Identifying treatments for male infertility has received limited focus, partly because of the success of assisted reproductive techniques (ART), where only few spermatozoa are needed to fertilise the oocyte in vitro. The successful development of ART has created a paradox because we now initiate treatment of the woman even when male-factor infertility is the cause of the couple's inability to conceive. Increased awareness of lower fertility rates, focus on reproductive problems, and the MeToo movement have stimulated interest in male infertility, although neither researchers, governments, nor the pharmaceutical industry are investing sufficient resources to revolutionise infertility treatment by developing innovative therapies for male infertility. This review summarises the challenges we face in developing novel treatment options for male infertility, highlights prior efforts and presents several considerations for future studies. Hopefully, in the near future, we will be able to offer treatment options for subsets of infertile men rather than solely relying on their healthy partners undergoing hormone treatment and subsequent ART, but this requires that authorities, funding bodies, researchers, the pharmaceutical industry and the infertile men themselves prioritise efforts to achieve this.