Publication:

Microbiome matters: the hidden influence of gut flora on male reproductive health

Male infertility is a complex disorder that affects about half of all cases worldwide. An increasing amount of research shows that the human microbiome has a significant impact on male reproductive health. Current understanding of how the gut, semen, and testicular bacteria affect reproductive results is studied in this review. Although bacteriospermia and poor semen parameters were linked in early culture-based investigations, microbial cultivation limits forced the use of sophisticated molecular approaches. The previous presumption of sterility has subsequently been challenged by metagenomic sequencing, especially next-generation sequencing (NGS), which has shown complex microbial communities in semen and testes. Changes in microbial composition, particularly in semen samples linked to assisted reproductive technologies (ART) and idiopathic non-obstructive azoospermia (iNOA), indicate dysbiosis may jeopardise sperm quality and the effectiveness of ART. Furthermore, a reciprocal relationship impacting hormonal balance and fertility is highlighted by interactions between the gut microbiota and androgen metabolism via the brain–gut–testis axis. Although the exact mechanisms are yet unknown, prebiotic and probiotic treatments have demonstrated promise in enhancing sperm motility, morphology, and DNA integrity. Current research is hindered by uneven methodology, a dearth of longitudinal data, and a lack of functional evaluations of spermatozoa, despite promising results. To demonstrate causality and therapeutic promise, future microbiome research must include stringent controls, longitudinal sampling, and thorough fertility evaluations. Knowing how the microbiome affects male fertility may help develop new probiotic-based therapies and diagnostic biomarkers, especially for cases of idiopathic infertility.