Fabio Castiglione: Integrating Prevention and Diagnosis in Male Infertility
Fabio Castiglione, Men’s Health Lead at Vira Health, shared a post on LinkedIn:
“Male infertility can no longer be treated as a secondary issue in reproductive care.
What stands out in this new framework is the shift toward a more structured and integrated view of male infertility: not only treatment, but also prevention, early triage, and a clearer diagnostic pathway.
A few points are particularly important:
- Semen analysis should be seen as a triage tool, not as a standalone diagnosis.
- Unexplained infertility should only be diagnosed after proper male assessment, including history, physical examination, and semen parameters.
- Targeted varicocele repair remains a key intervention in selected patients, with microsurgical approaches often preferred.
- Male reproductive health starts with prevention, including mitigation of modifiable risk factors, tobacco cessation, STI prevention, and reduction of oxidative and inflammatory damage.
This is an important step forward because it reinforces something clinicians working in andrology have known for years: male reproductive health must be assessed systematically, not superficially.
A more rigorous male evaluation means better diagnoses, more appropriate treatments, and ultimately better outcomes for couples.”

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