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Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such as machine learning, artificial neural networks, and deep learning, have shown great potential in andrology and reproductive medicine. AI-based tools are poised to become valuable assets with abilities to support and aid in diagnosing and treating male infertility, and in improving the accuracy of patient care. These automated, AI-based predictions may offer consistency and efficiency in terms of time and cost in infertility research and clinical management. In andrology and reproductive medicine, AI has been used for objective sperm, oocyte, and embryo selection, prediction of surgical outcomes, cost-effective assessment, development of robotic surgery, and clinical decision-making systems. In the future, better integration and implementation of AI into medicine will undoubtedly lead to pioneering evidence-based breakthroughs and the reshaping of andrology and reproductive medicine.
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Infertility affects nearly 186 million people worldwide and the male partner is the cause in about half of the cases. Meta-regression data indicate an unexplained decline in sperm concentration and total sperm count over the last four decades, with an increasing prevalence of male infertility. This suggests an urgent need to implement further basic and clinical research in Andrology. Andrology developed as a branch of urology, gynecology, endocrinology, and, dermatology. The first scientific journal devoted to andrological sciences was founded in 1969. Since then, despite great advancements, andrology has encountered several obstacles in its growth. In fact, for cultural reasons, the male partner has often been neglected in the diagnostic and therapeutic workup of the infertile couple. Furthermore, the development of assisted reproductive techniques (ART) has driven a strong impression that this biotechnology can overcome all forms of infertility, with a common belief that having a spermatozoon from a male partner (a sort of sperm donor) is all that is needed to achieve pregnancy. However, clinical practice has shown that the quality of the male gamete is important for a successful ART outcome. Furthermore, the safety of ART has been questioned because of the high prevalence of comorbidities in the offspring of ART conceptions compared to spontaneous conceptions. These issues have paved the way for more research and a greater understanding of the mechanisms of spermatogenesis and male infertility. Consequently, numerous discoveries have been made in the field of andrology, ranging from genetics to several "omics" technologies, oxidative stress and sperm DNA fragmentation, the sixth edition of the WHO manual, artificial intelligence, management of azoospermia, fertility in cancers survivors, artificial testis, 3D printing, gene engineering, stem cells therapy for spermatogenesis, and reconstructive microsurgery and seminal microbiome. Nevertheless, as many cases of male infertility remain idiopathic, further studies are required to improve the clinical management of infertile males. A multidisciplinary strategy involving both clinicians and scientists in basic, translational, and clinical research is the core principle that will allow andrology to overcome its limits and reach further goals. This state-of-the-art article aims to present a historical review of andrology, and, particularly, male infertility, from its "Middle Ages" to its "Renaissance", a golden age of andrology.
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INTRODUCTION: Testicular torsion is a sudden rotation of the testis towards its axis, which causes the twisting of the spermatic cord. Post-detorsion reperfusion will cause inflammation and trigger oxidative stress, which generates reactive oxygen species (ROS). Malondialdehyde (MDA) is an organic compound formed from ROS frequently used as an oxidative stress biomarker during ischemia and ischemia-reperfusion injury. In some organs, stem cell administration on the damaged organ is essential in preventing cellular damage and death. This study aimed to learn about the effect of hADSC administration on an ischemia-reperfusion injury. MATERIAL AND METHODS: A total of 22 Wistar rats divided into 5 groups, two groups each consist of 5 male Wistar rats with testicular torsion model without hADSC therapy (group I), while 2 other groups consist of 5 rats with testicular torsion model were given 1.0×106 cells intratesticular hADSC injection 30 minutes after testicular detorsion (group II). Both groups were euthanized at 1 and 4 weeks of observation. The last group consists of 2 rats without any treatment or model (negative control group). Following euthanasia, testicular tissue was harvested for MDA expression measurement using ELISA and histopathological examination. Statistical analysis using an one way ANOVA was done with SPSS version 21.0. RESULTS: The result of MDA examination using the ELISA method has shown a concentration difference between group I (control) and group II (hADSC treatment). Testicular MDA concentration in the treatment group was significantly lower on the 1st and 4th week of observation (p2=0.000, p4=0.016). Post hoc analysis showed no statistically different between therapy and healthy group (p=0.972). On histopathological examination, Johnsen score in the treatment group was significantly higher on the 4th week of observation (p=0.044). Post hoc analysis showed no statistically different between therapy and healthy group (p=0.195). CONCLUSION: Intratesticular hADSC administration can inhibit ROS formation due to ischemia-reperfusion injury in testicular tissue after testicular detorsion in Wistar rats.