Male Infertility: A Narrative Review of Epidemiology and Public Health Implications

Background: Male infertility is an under-recognised global public health issue, contributing significantly to childlessness worldwide. Defined as the inability to achieve spontaneous conception after 12 months of regular, unprotected intercourse, the male factor alone accounts for 20–30% of infertility cases and contributes to nearly half of all infertility globally. Objective: This review synthesises current epidemiological data and explores the multifactorial aetiology of male infertility, integrating genetic, environmental, lifestyle, and infectious contributors within a framework that considers both hereditary pre dispositions and broader environmental influences. Methods: A narrative review with systematic search methods was conducted using PubMed, Scopus, and Web of Science for articles published between 2000 and 2024. Inclusion criteria focused on peer-reviewed articles, meta-analyses, systematic re views, and reports from major health organisations (primarily WHO) providing data on prevalence, aetiology, or public health impact of male infertility. Non-English studies and studies focusing solely on female infertility or non-human subjects were ex cluded. Data were extracted and synthesised thematically. Results: Evidence indicates a global decline in sperm quality, largely attributed to environmental and lifestyle factors, including pollutants, obesity, and substance use. Regional variations exist, with prevalence ranging from 7–10% in North America and Europe to 12–14% in South Asia and Sub-Saharan Africa. Male infertility is associated with substantial psychosocial and medi cal repercussions, including impacts on mental health and population dynamics. Conclusion: Male infertility remains an under-addressed public health challenge with implications for reproductive health, so cial well-being, and healthcare equity. Strategies should emphasise preventive measures, early iagnosis, accessible treatment options, and destigmatisation initiatives, including integration of male infertility screening into primary healthcare, policy devel opment for affordable assisted reproductive technologies, and public awareness campaigns.