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Abstract：
BACKGROUND: The widespread interest in male reproductive health (MRH), fueled by emerging evidence, such as the global decline in sperm counts, has intensified concerns about the status of MRH. Consequently, there is a pressing requirement for a strategic, systematic approach to identifying critical questions, collecting pertinent information, and utilizing these data to develop evidence-based strategies. The methods for addressing these questions and the pathways toward their answers will inevitably vary based on the variations in cultural, geopolitical, and health-related contexts. To address these issues, a conjoint ESHRE and Male Reproductive Health Initiative (MRHI) Campus workshop was convened.
OBJECTIVE: The three objectives were: first, to assess the current state of MRH around the world; second, to identify some of the key gaps in knowledge; and, third, to examine how MRH stakeholders can collaboratively generate intelligent and effective paths forward.
METHODS: Each expert reviewed and summarized the current literature that was subsequently used to provide a comprehensive overview of challenges related to MRH.
RESULTS: This narrative report is an overview of the data, opinions, and arguments presented during the workshop. A number of outcomes are presented and can be summarized by the following overarching themes: MRH is a serious global issue and there is a plethora of gaps in our understanding; there is a need for widespread international collaborative networks to undertake multidisciplinary research into fundamental issues, such as lifestyle/environmental exposure studies, and high-quality clinical trials; and there is an urgent requirement for effective strategies to educate young people and the general public to safeguard and improve MRH across diverse population demographics and resources.
CONCLUSIONS: This was a workshop where worldwide leading experts from a wide range of disciplines presented and discussed the evidence regarding challenges related to MRH. While each expert summarized the current literature and placed it in context, the data in a number of areas are limited and/or sparse. Equally, important areas for consideration may have been missed. Moreover, there are clear gaps in our knowledge base, which makes some conclusions necessarily speculative and warranting of further study.
CONCLUSIONS: Poor MRH is a global issue that suffers from low awareness among the public, patients, and heathcare professionals. Addressing this will require a coordinated multidisciplinary approach. Addressing the significant number of knowledge gaps will require policy makers prioritizing MRH and its funding.
BACKGROUND: The authors would like to extend their gratitude to ESHRE for providing financial support for the Budapest Campus Workshop, as well as to Microptic S.L. (Barcelona) for kindly sponsoring the workshop. P.B. is the Director of the not-for-profit organization Global Action on Men\'s Health and receives fees and expenses for his work, (which includes the preparation of this manuscript). Conflicts of interest: C.J.D.J., C.L.R.B., R.A.A., P.B., M.P.C., M.L.E., N.G., N.J., C.K., AAP, M.K.O., S.R.-H., M.H.V.-L.: ESHRE Campus Workshop 2022 (Travel support-personal). C.J.D.J.: Cambridge University Press (book royalties-personal). ESHRE Annual Meeting 2022 and Yale University Panel Meeting 2023 (Travel support-personal). C.L.R.B.: Ferring and IBSA (Lecture), RBMO editor (Honorarium to support travel, etc.), ExSeed and ExScentia (University of Dundee), Bill & Melinda Gates Foundation (for research on contraception). M.P.C.: Previously received funding from pharmaceutical companies for health economic research. The funding was not in relation to this work and had no bearing on the contents of this work. No funding from other sources has been provided in relation to this work (funding was provided to his company Global Market Access Solutions). M.L.E.: Advisor to Ro, Doveras, Next, Hannah, Sandstone. C.K.: European Academy of Andrology (Past president UNPAID), S.K.: CEO of His Turn, a male fertility Diagnostic and Therapeutic company (No payments or profits to date). R.I.M.: www.healthymale.org.au (Australian Government funded not for profit in men\'s health sector (Employed as Medical Director 0.2 FET), Monash IVF Pty Ltd (Equity holder)). N.J.: Merck (consulting fees), Gedeon Richter (honoraria). S.R.-H.: ESHRE (Travel reimbursements). C.N.: LLC (Nursing educator); COMMIT (Core Outcomes Measures for Infertility Trials) Advisor, meeting attendee, and co-author; COMMA (Core Outcomes in Menopause) Meeting attendee, and co-author; International Federation of Gynecology and Obstetrics (FIGO) Delegate Letters and Sciences; ReproNovo, Advisory board; American Board of Urology Examiner; American Urological Association Journal subsection editor, committee member, guidelines co-author Ferring Scientific trial NexHand Chief Technology Officer, stock ownership Posterity Health Board member, stock ownership. A.P.: Economic and Social Research Council (A collaborator on research grant number ES/W001381/1). Member of an advisory committee for Merck Serono (November 2022), Member of an advisory board for Exceed Health, Speaker fees for educational events organized by Mealis Group; Chairman of the Cryos External Scientific Advisory Committee: All fees associated with this are paid to his former employer The University of Sheffield. Trustee of the Progress Educational Trust (Unpaid). M.K.O.: National Health and Medical Research Council and Australian Research Council (Funding for research of the topic of male fertility), Bill and Melinda Gates Foundation (Funding aimed at the development of male gamete-based contraception), Medical Research Future Fund (Funding aimed at defining the long-term consequences of male infertility). M.H.V.-L.: Department of Sexual and Reproductive Health and Research (SRH)/Human Reproduction Programme (HRP) Research Project Panel RP2/WHO Review Member; MRHI (Core Group Member), COMMIT (member), EGOI (Member); Human Reproduction (Associate Editor), Fertility and Sterility (Editor), AndroLATAM (Founder and Coordinator).
OBJECTIVE: The three objectives were: first, to assess the current state of MRH around the world; second, to identify some of the key gaps in knowledge; and, third, to examine how MRH stakeholders can collaboratively generate intelligent and effective paths forward.
METHODS: Each expert reviewed and summarized the current literature that was subsequently used to provide a comprehensive overview of challenges related to MRH.
RESULTS: This narrative report is an overview of the data, opinions, and arguments presented during the workshop. A number of outcomes are presented and can be summarized by the following overarching themes: MRH is a serious global issue and there is a plethora of gaps in our understanding; there is a need for widespread international collaborative networks to undertake multidisciplinary research into fundamental issues, such as lifestyle/environmental exposure studies, and high-quality clinical trials; and there is an urgent requirement for effective strategies to educate young people and the general public to safeguard and improve MRH across diverse population demographics and resources.
CONCLUSIONS: This was a workshop where worldwide leading experts from a wide range of disciplines presented and discussed the evidence regarding challenges related to MRH. While each expert summarized the current literature and placed it in context, the data in a number of areas are limited and/or sparse. Equally, important areas for consideration may have been missed. Moreover, there are clear gaps in our knowledge base, which makes some conclusions necessarily speculative and warranting of further study.
CONCLUSIONS: Poor MRH is a global issue that suffers from low awareness among the public, patients, and heathcare professionals. Addressing this will require a coordinated multidisciplinary approach. Addressing the significant number of knowledge gaps will require policy makers prioritizing MRH and its funding.
BACKGROUND: The authors would like to extend their gratitude to ESHRE for providing financial support for the Budapest Campus Workshop, as well as to Microptic S.L. (Barcelona) for kindly sponsoring the workshop. P.B. is the Director of the not-for-profit organization Global Action on Men\'s Health and receives fees and expenses for his work, (which includes the preparation of this manuscript). Conflicts of interest: C.J.D.J., C.L.R.B., R.A.A., P.B., M.P.C., M.L.E., N.G., N.J., C.K., AAP, M.K.O., S.R.-H., M.H.V.-L.: ESHRE Campus Workshop 2022 (Travel support-personal). C.J.D.J.: Cambridge University Press (book royalties-personal). ESHRE Annual Meeting 2022 and Yale University Panel Meeting 2023 (Travel support-personal). C.L.R.B.: Ferring and IBSA (Lecture), RBMO editor (Honorarium to support travel, etc.), ExSeed and ExScentia (University of Dundee), Bill & Melinda Gates Foundation (for research on contraception). M.P.C.: Previously received funding from pharmaceutical companies for health economic research. The funding was not in relation to this work and had no bearing on the contents of this work. No funding from other sources has been provided in relation to this work (funding was provided to his company Global Market Access Solutions). M.L.E.: Advisor to Ro, Doveras, Next, Hannah, Sandstone. C.K.: European Academy of Andrology (Past president UNPAID), S.K.: CEO of His Turn, a male fertility Diagnostic and Therapeutic company (No payments or profits to date). R.I.M.: www.healthymale.org.au (Australian Government funded not for profit in men\'s health sector (Employed as Medical Director 0.2 FET), Monash IVF Pty Ltd (Equity holder)). N.J.: Merck (consulting fees), Gedeon Richter (honoraria). S.R.-H.: ESHRE (Travel reimbursements). C.N.: LLC (Nursing educator); COMMIT (Core Outcomes Measures for Infertility Trials) Advisor, meeting attendee, and co-author; COMMA (Core Outcomes in Menopause) Meeting attendee, and co-author; International Federation of Gynecology and Obstetrics (FIGO) Delegate Letters and Sciences; ReproNovo, Advisory board; American Board of Urology Examiner; American Urological Association Journal subsection editor, committee member, guidelines co-author Ferring Scientific trial NexHand Chief Technology Officer, stock ownership Posterity Health Board member, stock ownership. A.P.: Economic and Social Research Council (A collaborator on research grant number ES/W001381/1). Member of an advisory committee for Merck Serono (November 2022), Member of an advisory board for Exceed Health, Speaker fees for educational events organized by Mealis Group; Chairman of the Cryos External Scientific Advisory Committee: All fees associated with this are paid to his former employer The University of Sheffield. Trustee of the Progress Educational Trust (Unpaid). M.K.O.: National Health and Medical Research Council and Australian Research Council (Funding for research of the topic of male fertility), Bill and Melinda Gates Foundation (Funding aimed at the development of male gamete-based contraception), Medical Research Future Fund (Funding aimed at defining the long-term consequences of male infertility). M.H.V.-L.: Department of Sexual and Reproductive Health and Research (SRH)/Human Reproduction Programme (HRP) Research Project Panel RP2/WHO Review Member; MRHI (Core Group Member), COMMIT (member), EGOI (Member); Human Reproduction (Associate Editor), Fertility and Sterility (Editor), AndroLATAM (Founder and Coordinator).
摘要：
背景：对男性生殖健康（MRH）的广泛兴趣，在新出现的证据的推动下，例如全球精子数量的下降，加剧了对MRH状况的担忧。因此,这是一个紧迫的战略要求，识别关键问题的系统方法，收集相关信息，并利用这些数据来制定基于证据的策略。解决这些问题的方法和答案的途径将不可避免地根据文化的变化而变化，地缘政治,以及与健康相关的环境。为了解决这些问题,召开了ESHRE和男性生殖健康倡议（MRHI）校园研讨会。
目标：三个目标是：第一，评估全球MRH的现状；第二，找出知识方面的一些关键差距；以及第三,检查MRH利益相关者如何协作生成智能有效的前进路径。
方法：每位专家回顾并总结了当前的文献，这些文献随后用于提供与MRH相关的挑战的全面概述。
结果：本叙述性报告是对数据的概述，意见,和研讨会期间提出的论点。提出了一些成果，可以总结为以下总体主题：MRH是一个严重的全球性问题，我们的理解存在过多的差距；需要广泛的国际合作网络对基本问题进行多学科研究，如生活方式/环境暴露研究，和高质量的临床试验；迫切需要有效的策略来教育年轻人和公众，以保护和改善不同人口统计学和资源的MRH。
结论：这是一个研讨会，来自广泛学科的全球领先专家介绍并讨论了与MRH相关挑战的证据。虽然每位专家都总结了当前的文献并将其置于上下文中，例如,多个区域中的数据是有限的和/或稀疏的。同样,可能错过了重要的考虑领域。此外，我们的知识库存在明显的差距，这使得一些结论必然是推测性的，有必要进一步研究。
结论：不良的MRH是一个全球性问题，受到公众认识不足的影响，病人,和医疗专业人员。解决这一问题将需要采取协调一致的多学科方法。解决大量的知识差距将需要决策者优先考虑MRH及其资金。
背景：作者对ESHRE为布达佩斯校园研讨会提供资金支持表示感谢，以及MicropticS.L.（巴塞罗那）赞助研讨会。P.B.是非营利组织全球男性健康行动的主任，并收取其工作费用和费用，（其中包括本手稿的准备）。利益冲突：C.J.D.J.,C.L.R.B.,R.A.A.,P.B.,M.P.C.,M.L.E.,N.G.,N.J.,C.K.,AAP,M.K.O.,S.R.-H.,M.H.V.-L.：ESHRE校园研讨会2022（个人旅行支持）。C.J.D.J.：剑桥大学出版社（图书版税-个人）。ESHRE年会2022和耶鲁大学小组会议2023（旅行支持-个人）。C.L.R.B.：Ferring和IBSA（讲座），RBMO编辑（支持旅行的荣誉，等。),ExSeed和ExScentia（邓迪大学），比尔和梅林达·盖茨基金会（避孕研究）。M.P.C.：以前从制药公司获得了用于健康经济研究的资金。资金与这项工作无关，也与这项工作的内容无关。没有从其他来源提供与这项工作有关的资金(资金提供给他的公司全球市场准入解决方案)。M.L.E.：Ro的顾问，Doveras,接下来,汉娜,砂岩。C.K.：欧洲男科学院（前任主席UNPAID），S.K.：轮到他的首席执行官，男性生育诊断和治疗公司(迄今为止没有付款或利润)。R.I.M.:www.healthymale.org.au(澳大利亚政府资助男性健康部门不盈利(受聘为医疗总监0.2FET)，莫纳什IVF私人有限公司（股权持有人））。新泽西州：默克公司（咨询费），GedeonRichter（酬金）。S.R.-H.：ESHRE（旅行报销）。C.N.：LLC（护理教育者）；COMMIT（不孕症试验的核心成果措施）顾问，会议与会者，和合著者；COMMA(更年期的核心成果)会议与会者，和合著者；国际妇产科联合会（FIGO）代表信件和科学；ReproNovo，顾问委员会；美国泌尿外科考试委员会；美国泌尿外科协会期刊分节编辑，委员,指南合著者Ferring科学试验NexHand首席技术官，股票所有权后代健康委员会成员，股票所有权。A.P.：经济和社会研究理事会（研究补助金合作者，编号ES/W001381/1）。默克Serono咨询委员会成员（2022年11月），过度健康咨询委员会成员，MealisGroup组织的教育活动的演讲者费用；Cryos外部科学咨询委员会主席：与此相关的所有费用均支付给他的前雇主谢菲尔德大学。进步教育信托基金的受托人(未支付)。M.K.O.：国家健康与医学研究委员会和澳大利亚研究委员会（资助研究男性生育能力），比尔和梅琳达·盖茨基金会（资助旨在开发基于男性配子的避孕方法），医学研究未来基金（旨在定义男性不育的长期后果的资金）。M.H.V.-L.：性健康和生殖健康与研究部（SRH）/人类生殖计划（HRP）研究项目小组RP2/WHO审查成员；MRHI（核心小组成员），COMMIT(member),EGOI（成员）；人类繁殖（副主编），生育和不育（编辑），AndroLATAM（创始人和协调员）。
目标：三个目标是：第一，评估全球MRH的现状；第二，找出知识方面的一些关键差距；以及第三,检查MRH利益相关者如何协作生成智能有效的前进路径。
方法：每位专家回顾并总结了当前的文献，这些文献随后用于提供与MRH相关的挑战的全面概述。
结果：本叙述性报告是对数据的概述，意见,和研讨会期间提出的论点。提出了一些成果，可以总结为以下总体主题：MRH是一个严重的全球性问题，我们的理解存在过多的差距；需要广泛的国际合作网络对基本问题进行多学科研究，如生活方式/环境暴露研究，和高质量的临床试验；迫切需要有效的策略来教育年轻人和公众，以保护和改善不同人口统计学和资源的MRH。
结论：这是一个研讨会，来自广泛学科的全球领先专家介绍并讨论了与MRH相关挑战的证据。虽然每位专家都总结了当前的文献并将其置于上下文中，例如,多个区域中的数据是有限的和/或稀疏的。同样,可能错过了重要的考虑领域。此外，我们的知识库存在明显的差距，这使得一些结论必然是推测性的，有必要进一步研究。
结论：不良的MRH是一个全球性问题，受到公众认识不足的影响，病人,和医疗专业人员。解决这一问题将需要采取协调一致的多学科方法。解决大量的知识差距将需要决策者优先考虑MRH及其资金。
背景：作者对ESHRE为布达佩斯校园研讨会提供资金支持表示感谢，以及MicropticS.L.（巴塞罗那）赞助研讨会。P.B.是非营利组织全球男性健康行动的主任，并收取其工作费用和费用，（其中包括本手稿的准备）。利益冲突：C.J.D.J.,C.L.R.B.,R.A.A.,P.B.,M.P.C.,M.L.E.,N.G.,N.J.,C.K.,AAP,M.K.O.,S.R.-H.,M.H.V.-L.：ESHRE校园研讨会2022（个人旅行支持）。C.J.D.J.：剑桥大学出版社（图书版税-个人）。ESHRE年会2022和耶鲁大学小组会议2023（旅行支持-个人）。C.L.R.B.：Ferring和IBSA（讲座），RBMO编辑（支持旅行的荣誉，等。),ExSeed和ExScentia（邓迪大学），比尔和梅林达·盖茨基金会（避孕研究）。M.P.C.：以前从制药公司获得了用于健康经济研究的资金。资金与这项工作无关，也与这项工作的内容无关。没有从其他来源提供与这项工作有关的资金(资金提供给他的公司全球市场准入解决方案)。M.L.E.：Ro的顾问，Doveras,接下来,汉娜,砂岩。C.K.：欧洲男科学院（前任主席UNPAID），S.K.：轮到他的首席执行官，男性生育诊断和治疗公司(迄今为止没有付款或利润)。R.I.M.:www.healthymale.org.au(澳大利亚政府资助男性健康部门不盈利(受聘为医疗总监0.2FET)，莫纳什IVF私人有限公司（股权持有人））。新泽西州：默克公司（咨询费），GedeonRichter（酬金）。S.R.-H.：ESHRE（旅行报销）。C.N.：LLC（护理教育者）；COMMIT（不孕症试验的核心成果措施）顾问，会议与会者，和合著者；COMMA(更年期的核心成果)会议与会者，和合著者；国际妇产科联合会（FIGO）代表信件和科学；ReproNovo，顾问委员会；美国泌尿外科考试委员会；美国泌尿外科协会期刊分节编辑，委员,指南合著者Ferring科学试验NexHand首席技术官，股票所有权后代健康委员会成员，股票所有权。A.P.：经济和社会研究理事会（研究补助金合作者，编号ES/W001381/1）。默克Serono咨询委员会成员（2022年11月），过度健康咨询委员会成员，MealisGroup组织的教育活动的演讲者费用；Cryos外部科学咨询委员会主席：与此相关的所有费用均支付给他的前雇主谢菲尔德大学。进步教育信托基金的受托人(未支付)。M.K.O.：国家健康与医学研究委员会和澳大利亚研究委员会（资助研究男性生育能力），比尔和梅琳达·盖茨基金会（资助旨在开发基于男性配子的避孕方法），医学研究未来基金（旨在定义男性不育的长期后果的资金）。M.H.V.-L.：性健康和生殖健康与研究部（SRH）/人类生殖计划（HRP）研究项目小组RP2/WHO审查成员；MRHI（核心小组成员），COMMIT(member),EGOI（成员）；人类繁殖（副主编），生育和不育（编辑），AndroLATAM（创始人和协调员）。
