Background: Male infertility (MI) has become an important public health concern in Central Asia (CA), where declining fertility coincides with limited integration of male reproductive health into national strategies. This study analyzed trends in the prevalence and burden of MI in CA countries and assessed associations with selected modifiable behavioral risk factors. Methods: A longitudinal analysis of Global Burden of Disease (GBD) 2023 data was conducted to estimate the age-standardized prevalence and incidence of MI among men aged 15–49 years in five CA countries from 1990 to 2023. Trends were examined, and fixed-effects panel regression models were applied to evaluate associations between MI burden and alcohol use, drug use, and sexually transmitted infections (excluding HIV). Results: From 1991 to 2023, the age-standardized prevalence increased in four CA countries, whereas Tajikistan showed a decline; the incidence rose across all countries. The peak incidence was most commonly observed at ages 35–39 years, although Tajikistan shifted toward a younger age group, and regression analyses revealed heterogeneous country-specific associations with sociobehavioral risk factors. Conclusions: MI represents a significant demographic and public health challenge in CA, highlighting the need to strengthen surveillance, standardize diagnostics, improve access to care, and integrate male reproductive health into national prevention strategies.

The objective of this review is to synthesize current knowledge and evidence on male reproductive health by addressing preventive medicine strategies and biomarkers, as well as to provide clinicians, researchers, and policy makers with a coherent framework for prevention of male reproductive health. In this review male (in)fertility and determinants of male reproductive health as well as preventive strategies with special attention to primary, secondary and tertiary prevention in male reproductive health will be analyzed. From primary preventive measures: education, weight management, physical activity, sleep, healthy diet, alcohol and smoking consumption will be assessed, while from secondary preventive measures: sexually transmitted infection (STI) from the point of transmission prevention, testicular self-examination, hormonal testing and management, chronic diseases and semen analysis will be discussed; and from tertiary preventive measures: treatment of STI, treatment of congenital abnormalities, infertility treatment and urogenital cancer treatment will be elaborated. Additionally, biomarkers in male reproductive health will be synthesized and discussed. Bridging the gap between evidence and practice will ultimately lead to better understanding of the complex state of male reproductive health, thus minimizing the potential missed windows of opportunities in timely adequate preventive interventions implementations, as well as on time diagnostic and optimal treatment options.