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Sandro Esteves: APHRODITE Criteria for More Targeted Male Infertility Care

Sandro Esteves/LinkedIn

Apr 25, 2026, 06:07

Sandro Esteves: APHRODITE Criteria for More Targeted Male Infertility Care

Sandro Esteves, Honorary Professor of Reproductive Medicine at Aarhus University, shared a post on LinkedIn:

“Despite advances in ART, many men are still managed with oral agents prescribed without a clear endocrine rationale, often with variable and modest effects. This approach contrasts sharply with what we have learned in female reproductive medicine, where treatment evolved toward physiology-driven strategies.

In this opinion article co-authored with Peter Humaidan, we revisit that gap and argue that the field is ready for a shift.

The APHRODITE criteria integrate patient clinical characteristics, endocrine phenotype, and spermatogenic status to align treatment with underlying biology rather than empirical convention.

A key implication is the repositioning of gonadotropins—not as a last resort, but as a rational, earlier-line option in selected patients. Unlike oral agents (e.g., SERMS, AIs), gonadotropins act directly at the testicular level, restoring the physiological drivers of spermatogenesis.
This is not about replacing one treatment with another.
It is about abandoning non-stratified care.

As in ovarian stimulation, progress in male infertility will likely depend on recognizing that biological heterogeneity matters—and that treatment should follow phenotype, not habit.

The next step is clear: prospective evidence built around APHRODITE-defined phenotypes. Until then, continuing purely empirical therapy without phenotyping may no longer be justifiable.”

Title: From tablets to targeted therapy: the APHRODITE era in male infertility

Authors:Sandro C Esteves , Peter Humaidan

Read the full article.

academic.oup.com