Restoring Male Fertility: A Training Course

In 2024, the Unit of Andrology and Reproductive Medicine of the Department of Medicine at the University of Padova, Italy held its first international high level training course on Reparative Medicine for Male Reproductive Health. The course trained several physicians from different countries in the diagnosis and treatment of male factor infertility with the aim of restoring natural fertility. This year, a second edition of the course will be offered and CMA members in related fields are encouraged to attend.

The target of the course is not only training in Andrological Reparative Medicine, but also building a network between professionals involved in this field, including gynecologists, endocrinologists, andrologists, urologists and psychologists. More than simply treating, it is time to develop an integral strategy of care for infertile couples, based on evidence and high scientific standards and a solid bioethical foundation.

Couple infertility is a common clinical condition. It is the lack of conception after at least 12 months of regular unprotected sexual intercourse aimed at pregnancy. About 10% of couples in the world are infertile, with 56% of them seeking medical care. A male factor contributes to 30–50% of infertility cases, representing approximately 1 in 20 men in western societies.

While poorly quantified at a social and financial level, male infertility is a highly significant medical and social problem. It contributes to the growing use of assisted reproduction technology (ART) and substantial costs to individuals and the health systems. In addition, previous data reported that infertile men have a significantly higher incidence of comorbidities than fertile men. As such, a better understanding of the etiology of male infertility may have a pivotal role in male health promotion strategies and general health management.

Other important data: 30-50% of male patients with infertility and reduction in semen parameters are classified with “idiopathic infertility” and often directly referred in clinical practice to ART. Moreover, according to medical literature, 30–40% of patients do not receive care based on available scientific evidence. Therefore, an estimated 20–25% of provided health care is unnecessary. In the case of infertility care, this could mean the use of unnecessary and expensive diagnostic tests and the overuse of ART. It has been demonstrated that approximately 15% of couples still undergo ART without any previous andrological evaluation in the real-life setting.

This trend has been confirmed in recent years. However, over the past two decades, there has been concern about the overuse of ART because of the lack of evidence of effectiveness, especially in certain populations (e.g. unexplained infertility), potential short and long-term risks for the baby, and economic considerations. Furthermore, ART presents ethical problems to be respected and taken into consideration, including the in-vitro production of human embryos, the percentage of embryos lost during the technique (about 90%) and ethical questions related to the dignity of procreation.

With the recent studies of the Unit of Andrology and Reproductive Medicine at the University of Padova, it can be affirmed that a complete diagnostic and therapeutic approach may restore natural fertility in more than 40% of couples, including a group of patients with previous history of ART failure (pregnancy rate in this group is 25%), thus representing an alternative approach to ART, which combines the style of Jérôme Lejeune’s medical and human approach, scientific rigor and respect for the ethical issues regarding the dignity of human life.

The 2025 second edition of the Reparative Medicine for Male Reproductive Health course will take place in collaboration with Fertilitas, Spain’s leading NaProTechnology clinic and the International Chair of Bioethics Jérôme Lejeune (ICBJL), an international think tank based in Spain but active worldwide. ICBJL focuses on education, research and publishing on bioethics and the defense of life from conception to natural death, following the path of Dr. Jérôme Lejeune.

This year’s partnership with the ICBJL looks at underlining the importance of the bioethical framework in reproductive issues and how the possibilities of restoring natural fertility might represent an option to respond to couples’ desires, not only in the perspective of good deontological medicine, but also in terms of ethical choices, respecting life from conception and the dignity of procreation.

To learn more about the course and to register, click here.

Dr. Giuseppe Grande is the vice-director of the Reparative Medicine for Male Reproductive Health course.