A narrative review on the role of autophagy in male infertility-associated sperm abnormalities

A review of animal and lab data argues autophagy imbalance may drive low sperm count and motility, no new evidence

Journal: Asian Journal of Andrology | Published: 2026-01-20 | Type: Journal Article, Review | PMID: 41556614 Authors: Jin Yi-Han, Gao Da-Wei, Li Chu-Yu, Mo Hui (Faculty of Chinese Medicine, Macau University of Science and Technology); Sun Da-Lin, Jin Bao-Fang (Andrology Department of Integrative Medicine, Zhongda Hospital, Southeast University, Nanjing) Funding/COI: Not listed in the record

Summary

This is a narrative review, not a new study — the authors read existing basic-science and clinical papers on autophagy (the cell's process for degrading and recycling its own components) and synthesized what's known about its role in sperm production and quality. The core argument is that too much or too little autophagic activity in testicular and sperm cells correlates with oligozoospermia (low count), asthenozoospermia (poor motility), teratozoospermia (abnormal shape), and azoospermia (no sperm). No original data, patients, or statistics are generated here — it's a synthesis of other people's findings.

Claims

• Autophagy is described as necessary for normal spermatogenesis and sperm maturation, based on prior animal-model and cell-culture work cited in the review
• Dysregulated autophagy — either excessive or insufficient — is associated with oligozoospermia, asthenozoospermia, teratozoospermia, and azoospermia in the studies compiled
• The authors propose autophagy-related pathways as candidate targets for future infertility treatments, based on mechanistic (not clinical trial) evidence

Study Quality

This is a narrative review, the weakest tier of review methodology — it has no registered protocol, no systematic search strategy, no predefined inclusion/exclusion criteria, and no quality scoring of the underlying studies, unlike a systematic review or meta-analysis. That means the authors chose which papers to include, which makes cherry-picking of favorable mechanistic results hard to rule out from the abstract alone.

The underlying evidence base itself is largely preclinical: the MeSH terms list "Animals" alongside "Humans," indicating a substantial share of the cited mechanistic work comes from animal models or cell lines rather than human clinical studies. Nothing in the abstract indicates human interventional data — this is hypothesis-generating biology, not evidence that manipulating autophagy improves fertility outcomes in men.

Red Flags

• No funding source or conflict-of-interest disclosure listed
• Narrative review methodology — no systematic search, no PRISMA-style protocol, no way to verify the cited literature is representative rather than selective
• Mixes animal and human data without the abstract specifying the ratio or clearly separating what's been shown in men versus rodents/cell models
• "Therapeutic potential" language in the abstract is speculative — no clinical trial data on autophagy-targeting drugs for infertility is described

Strengths

• Addresses a genuine and active area of reproductive biology research
• Multidisciplinary authorship spanning basic andrology and integrative medicine departments
• Could be useful as a starting bibliography for researchers wanting a map of the autophagy-infertility mechanistic literature

Verdict

This is a bibliography with a thesis, not evidence — a mechanistic hypothesis paper compiling animal and cell-culture data with no systematic methodology, no funding disclosure, and no human trial results. Useful if you want a reading list on autophagy's role in spermatogenesis; useless if you're looking for anything that tells you whether targeting autophagy actually helps human male infertility.