Male infertility research for the ART clinic: priorities to enhance patient outcomes, education and wellbeing.

BACKGROUND: Men attending ART clinics often have poor fertility awareness and are typically overlooked for psychological support. Recent developments in understanding the link between sub-fertility, healthspan and lifespan enforce the need for comprehensive health assessments of men attending ART clinics. Evidence now suggests paternal factors including genetics, epigenetics, paternal age, oxidative stress and DNA damage contribute to embryo development and the health of the offspring. With the described decline in global sperm counts, overall male reproductive health and the increased utilisation of ART, it is imperative that research focuses on improving ART protocols for male factor infertility and investigates novel treatments for patients. Sperm contributions in ART are often overlooked, leading to optimisation of the clinical environment to focus on oocytes and embryos. Research into improving ART protocols for sperm is growing, but the clinical implementation has been slow. In parallel, current treatment options for male infertility are limited to procedures like ICSI, which bypass the underlying physiological causes of infertility. Ongoing research into sperm in clinical settings, as well as better patient psychosocial care, is therefore key to improving patient outcomes and wellbeing. OBJECTIVE AND RATIONALE: This review aims to evaluate the current standing of male reproductive health management in ART clinics with a unique focus on integrated patient care from men's fertility awareness, through to psychosocial support and targeted education. Additionally, this review aims to identify major barriers that currently prevent rapid integration of novel technologies for male infertility diagnostics and treatments into ART clinics. SEARCH METHODS: PubMed searches were performed to identify peer-reviewed articles and reviews using the following terms: 'sperm preparation/selection', 'male reproductive health', 'male infertility', 'diagnostics', 'cryopreservation', 'ART', 'fertility education', 'fertility awareness', 'artificial intelligence', and 'sperm' in combination with other key words related to the subject. No restriction was placed on date; all relevant studies up until March 2026 were evaluated and discussed. References within articles were also searched. OUTCOMES: In an ART setting, men rarely receive routine healthcare follow-up after providing a sample for assisted reproduction. Through integration of several underrepresented aspects of male health care, this review concludes that male reproductive health should be managed more collaboratively by medical specialists, including general practitioners, urologists, endocrinologists and andrologists, to understand the underlying cause of male infertility and determine an appropriate treatment. Moreover, this review finds that the integration of mental health professionals into the ART clinic environment is urgently needed to ensure appropriate counselling and care for people during and following fertility treatment. Finally, we determined that a lack of direct collaboration between researchers and clinical practitioners may be partly responsible for the slow uptake of novel technologies into the ART clinic. WIDER IMPLICATIONS: Further research needs to be undertaken to improve public health messaging and education for men about their fertility. An overarching theme identified by this review is the need for targeted collaboration between research scientists and clinicians to improve men's reproductive care, in turn, culminating in faster clinical adoption of beneficial techniques and products to improve patient outcomes. This review highlights an urgent need for more integrated models of fertility care that extend from men's fertility awareness and education, through to improvements of 'in clinic' appraisal of the underlying causes of male infertility, and finally, better inclusion of men's psychosocial support into reproductive care. REGISTRATION NUMBER: n/a.