Impact of male genital tract infections on semen quality: a systematic review and meta-analysis

Fertility and Sterility · 2026-03-11

Editorial Comment on “In Vitro Fertilization Utilization Rates and Outcomes in States With and Without Insurance Coverage Mandates for Male Infertility Care”

Urology · 2026-02-20

(189) Effects of GLP-1 Receptor Agonists on Erectile Function and Ejaculation: A Systematic Review

The Journal of Sexual Medicine · 2025-11-01

Abstract Introduction Erectile dysfunction (ED) and ejaculatory disorders are common manifestations of male sexual dysfunction, particularly in men with obesity and type 2 diabetes mellitus (T2DM). These metabolic conditions contribute to endothelial dysfunction, hormonal imbalance, and neuropathic changes that compromise penile hemodynamics and ejaculatory control. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), increasingly used for metabolic disease management, have demonstrated pleiotropic effects beyond glucose regulation. Emerging evidence suggests a potential role in modulating sexual function, but the extent and mechanism of this impact remain unclear. Objective To evaluate the effects of GLP-1 receptor agonists on erectile function and ejaculatory parameters in men and animal models through a systematic review of the literature. Methods A systematic search was conducted using the MEDLINE database to identify relevant articles published between 2014 and March 2025. Keywords and MeSH terms included combinations of “GLP-1 receptor agonist,” “Semaglutide,” “Liraglutide,” “Erectile dysfunction,” “Ejaculation,” “Penile erection,” and “Sexual function.” Included studies were original research involving either human participants or animal models, and must have reported outcomes related to erectile function (e.g., IIEF scores, intracavernosal pressure) or ejaculatory metrics. Review articles, editorials, and studies not reporting sexual function outcomes were excluded. Two authors independently screened titles, abstracts, and full texts using Covidence software. Results Of 20 total studies screened, 10 met inclusion criteria. Six studies involved human subjects and four were conducted in animal models. Among the six human studies, five examined erectile function-four using validated instruments such as the International Index of Erectile Function (IIEF). Three of these reported significant improvements in erectile performance following treatment with GLP-1 RAs, particularly in patients with obesity or T2DM. Improvements correlated with reductions in HbA1c, weight, and inflammatory markers. One study reported no significant change. Regarding ejaculation, two human studies explored ejaculatory latency or satisfaction; both reported no adverse effect and one suggested improved ejaculatory control. In animal models, three of the four studies showed enhancement of erectile response, demonstrated through increased intracavernosal pressure and improved endothelial nitric oxide synthase (eNOS) activity. These effects were hypothesized to be mediated by improved vascular function and reduced oxidative stress. None of the animal studies reported data on ejaculatory parameters. Conclusions GLP-1 receptor agonists may offer modest benefits in improving erectile function, particularly in metabolically compromised men. Evidence points to mechanisms involving improved endothelial health, hormonal modulation, and weight-related metabolic improvements. While human data on ejaculation is limited, existing findings do not suggest adverse effects and may hint at improved control in some cases. Further randomized, controlled trials are warranted to clarify the role of GLP-1 RAs in male sexual medicine and to delineate their effects on ejaculatory physiology. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Verity Pharma

(420) Peptide Therapies as Emerging Trends in Men’s Health

The Journal of Sexual Medicine · 2025-11-01

Abstract Introduction With the rise of direct-to-consumer men’s health clinics, there exists an interest in many novel therapies whose safety and efficacy have yet to be fully elucidated. Objective Herein we seek to evaluate the public interest in growth hormone peptides as a growing aspect of men’s health clinics. Methods We performed independent systematic searches via Google Trends using key words “Peptide”,”Peptide therapy”, and “growth hormone peptides.” From the “related topics” a list of all unique peptide therapies was accumulated. Unique peptides from resulting queries were interrogated until no new unique peptides resulted. Each individual peptide from this list was independently queried on Google Trends. Data was filtered for worldwide web search trends from January 2004 to August 2024 and reported as annual averages. All unique peptides were considered inclusion criteria. Excluded results included non-peptide therapies and GLP-1 agonists as their popularity is already well established. Results Sixteen individual peptide therapies were identified from our query. All agents exhibited an increase in search queries over the last 20 years (Figure 1). Conclusions Peptide therapy is steadily growing in public interest. It is important for practicing urologists to be aware of these trends as patients seek information regarding emerging therapies in men’s health. Disclosure No

(272) GLP-1 Agonists and Testosterone Deficiency: A Systematic Review of Clinical and Preclinical Evidence

The Journal of Sexual Medicine · 2025-11-01 · 1 citations

Abstract Introduction Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as powerful tools for weight reduction and glycemic control in patients with obesity and type 2 diabetes mellitus (T2DM). These metabolic conditions are closely associated with functional hypogonadism, a prevalent and underdiagnosed contributor to male sexual dysfunction, infertility, and reduced quality of life. The interplay between metabolic disease and the hypothalamic-pituitary-gonadal (HPG) axis has garnered increasing attention, yet the specific impact of GLP-1 agonists on testosterone production and gonadal function remains incompletely understood. Objective To systematically review the existing literature on the effects of GLP-1 receptor agonists on male hypogonadism, including changes in total and free testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), and clinical symptoms of androgen deficiency. Methods A systematic review was performed using the MEDLINE database to identify studies published between inception and March 2025. Search terms included combinations of “GLP-1 receptor agonist,” “Liraglutide,” “Semaglutide,” “Testosterone,” “Hypogonadism,” and related MeSH terms. Inclusion criteria were original studies (human or animal) reporting outcomes on reproductive hormone levels or hypogonadal symptoms. Exclusion criteria included studies without male-specific endocrine data, non-original research (e.g., editorials), or irrelevant endpoints. Two independent reviewers screened abstracts and full-texts using Covidence. Review articles and case reports were considered if they summarized relevant primary data. Results Of 101 studies identified, 97 were screened after duplicate removal. After abstract and full-text review, 23 studies met inclusion criteria. Of these, 11 involved human subjects and 12 used animal models. Among the human studies, 9 evaluated testosterone levels (total and/or free), 6 reported on gonadotropins (LH, FSH), and 5 assessed clinical hypogonadal symptoms such as libido and erectile function. In total, 7 human studies demonstrated a statistically significant increase in testosterone levels following GLP-1 agonist treatment, with stronger effects observed in men with obesity, T2DM, and baseline low testosterone. Two human studies showed no change or mild reductions in testosterone among eugonadal men without metabolic disease. Among the animal studies, 10 of 11 reported favorable effects on testicular morphology, hormone production, or HPG axis signaling. Across models, improvements were attributed both to weight-independent GLP-1R-mediated signaling and weight loss–associated metabolic normalization. Conclusions GLP-1 receptor agonists may offer dual metabolic and endocrine benefits in men with functional hypogonadism secondary to obesity or T2DM. Evidence supports a modest but consistent increase in testosterone and improvement in clinical symptoms of hypogonadism, particularly in metabolically impaired populations. These effects appear to be mediated through both weight loss and potential direct action on the HPG axis. However, GLP-1 agonists do not appear to significantly alter androgen status in metabolically healthy, eugonadal men. Further randomized trials are needed to establish therapeutic roles and clarify mechanisms of action. Disclosure No

BREAKING BARRIERS IN FERTILITY TESTING: COMPLETION TRENDS IN MAIL-IN SEMEN ANALYSES ACROSS FLORIDA

Fertility and Sterility · 2025-12-01

(302) Breaking Barriers in Fertility Testing: Completion Trends in Mail-in Semen Analyses Across Florida

The Journal of Sexual Medicine · 2025-11-01

Abstract Introduction Access to fertility care is essential to reproductive health, yet barriers are prevalent based on socioeconomic, geographic, and demographic factors. Mail-in semen analysis (SA) kits offer a potentially more accessible option for fertility testing; at-home testing has been shown to reduce healthcare costs and may offer increased convenience for patients. However, the social and demographic factors influencing patient completion with these kits remain largely unexplored, warranting further investigation. Objective This study evaluates completion rates of mail-in SA among men in Florida and identifies geographic, demographic, and socioeconomic factors associated with completion rates. Methods We conducted a prospective cohort study of adult men in Florida who ordered mail-in SA kits from Fellow Health between 9/3/2020 – 10/31/2024. ZIP code-level data was used to determine region (North/Panhandle, Central, South Florida) and urbanization status (urban vs. rural). Socioeconomic indices were assessed, including the Distressed Community Index (DCI), based on ZIP code-level data, and the Social Vulnerability Index (SVI), a location-based index stratified by census data on race, income, and housing status. Demographic data, ordering indication, and referring provider were also collected. The primary outcome was kit completion, defined as laboratory processing within 16 weeks of activation. Completion was compared using chi-square tests, and multivariable logistic regression was performed to assess independent predictors of completion. Results Among 2,282 men (mean age 35.7), overall completion was 91.8%. Completion rates were lowest among men ages 40-49, 88.6% (p<0.01); those living in rural areas, 93.1%; those living in South Florida, 94.3%; men referred by an Ob/Gyn, 85.7%; and men who ordered a test out of curiosity, 92.5% (p<0.01). Completion by urbanization, geographical region, DCI, and SVI were not significantly different, however after multivariable adjustment, living in the North Florida/ Panhandle region (OR 3.7, 95% CI 1.6-10.1), having an DCI index between 61-80% (OR 2.6, 95% CI 1.2-6.4), being referred by a Urology clinic (OR 2.0, 95% CI 1.2-3.2), and ordering a semen analysis after trying for 0-6 months were associated with higher completion rates (OR 2.7, 95% CI 1.3-6.3). Conclusions Mail-in SA kits demonstrate high overall completion in Florida, with certain demographic and referral factors influencing completion. These findings highlight the potential of mail-in testing to improve access to fertility care, though regional and provider-related disparities remain. Further research is warranted to understand lower completion in specific populations and ensure equitable follow-up care. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow Health, Inc.

Editorial Comment on “Cryptozoospermia in the Shadow of Azoospermia: Accurate Diagnosis With Clinical Predictors and Extended Semen Analysis”

Urology · 2025-08-05

Epidemiology, Clinical Features, and Outcomes of Pediatric Patients with Thoracic Neuroblastoma from 1997-2023

SSRN Electronic Journal · 2025-01-01

Kevin J. Campbell, MD, MS

The Journal of Urology · 2025-08-14