Background: A number of different types of endocrine‐disrupting chemicals (EDCs) including bisphenol A, phthalates, pesticides, and other environmental chemicals have been shown to adversely impact upon male reproductive health. Understanding the potential effects of EDCs on male reproductive health may enable the development of novel treatments and early prevention of the effects of EDCs on male infertility and their potential long‐term sequelae. This review critically evaluates the research performed in this area and explores potential harmful effects of EDCs in animals and humans, including the possibility of trans‐generational transmission.Methods: A literature review was conducted using electronic databases using the following terms: ‘endocrine disrupt*’ OR ‘endocrine disruptors’ OR ‘endocrine disruptor chemicals’ OR ‘EDC’ AND ‘sperm*’ OR ‘spermatozoa’ OR ‘spermatozoon’ OR ‘male reproductive health’ OR’ male fertility’.Main findings: Several studies have shown that EDCs have a variety of pathophysiological effects. These include failure of spermatogenesis, embryonic development, the association with testicular cancer, and long‐term metabolic effects.Conclusions: Several studies observe correlations between chemical doses and at least one sperm parameter; however, such correlations are sometimes inconsistent between different studies. Mechanisms through which EDCs exert their pathophysiological effects have not yet been fully elucidated in human studies.

The role of kisspeptin in stimulating hypothalamic GnRH is undisputed. However, the role of kisspeptin signaling in testicular function is less clear. The testes are essential for male reproduction through their functions of spermatogenesis and steroidogenesis. Our review focused on the current literature investigating the distribution, regulation and effects of kisspeptin and its receptor (KISS1/KISS1R) within the testes of species studied to date. There is substantial evidence of localised KISS1/KISS1R expression and peptide distribution in the testes. However, variability is observed in the testicular cell types expressing KISS1/KISS1R. Evidence is presented for modulation of steroidogenesis and sperm function by kisspeptin signaling. However, the physiological importance of such effects, and whether these are paracrine or endocrine manifestations, remain unclear.

Penile implant surgery-managing complications

Male infertility is a major health burden worldwide. In the United Kingdom, the diagnostic and treatment pathway for male factor fertility is fragmented with wide variance in management and funding protocols. There is now a focus on potential overtreatment of couples with IVF and failure to treat male factors before considering assisted reproductive technology (ART). Despite this, contemporary Urological guidelines are not definitive in the indications for varicocele treatment, whilst the current National Institute for Health and Care Excellence (NICE) guidelines do not advocate surgical intervention. While controversy exists concerning the effects of varicocele treatment on natural pregnancy rates, there is growing evidence that varicocele treatment can have additional positive effects on fertility by reducing their impact on sperm DNA fragmentation and improving ART outcomes. Studies have demonstrated that azoospermic men may become oligospermic following varicocele intervention, obviating the need for surgical sperm retrieval. Sperm retrieval rates also increase following varicocele treatment in men with non-obstructive azoospermia. The contemporary literature demonstrates a clear clinical benefit for treating varicoceles in infertile men, which may be more cost-effective than proceeding to immediate ART. This review comprehensively evaluates the current indications for varicocele treatment, and it is proposed that these should be redefined in contemporary guidelines to reflect current advances in male fertility research.