The article reviews recent advancements and challenges in the field of male infertility, highlighting new developments in diagnostics and treatment. Key areas discussed include seminal oxidative stress testing, sperm DNA fragmentation testing, genetic and epigenetic tests, genetic manipulations, artificial intelligence (AI), personalized medicine, and telemedicine. The role of the reproductive urologist is expanding to address diverse questions and controversies in the pathophysiology, diagnosis, and therapy of male infertility. The article also covers the impact of lifestyle factors, environmental pollutants, and the COVID-19 pandemic on male fertility. Additionally, it explores the use of AI in sperm analysis, home testing of semen, whole genome testing, epigenetic markers, seminal proteomics, radiomics, and the relationship between male fertility and general health. The future of stem cells in male infertility and the potential of AI in andrological surgeries are also discussed. The authors emphasize the importance of international initiatives and the need for continued research to improve the management of male infertility.The article reviews recent advancements and challenges in the field of male infertility, highlighting new developments in diagnostics and treatment. Key areas discussed include seminal oxidative stress testing, sperm DNA fragmentation testing, genetic and epigenetic tests, genetic manipulations, artificial intelligence (AI), personalized medicine, and telemedicine. The role of the reproductive urologist is expanding to address diverse questions and controversies in the pathophysiology, diagnosis, and therapy of male infertility. The article also covers the impact of lifestyle factors, environmental pollutants, and the COVID-19 pandemic on male fertility. Additionally, it explores the use of AI in sperm analysis, home testing of semen, whole genome testing, epigenetic markers, seminal proteomics, radiomics, and the relationship between male fertility and general health. The future of stem cells in male infertility and the potential of AI in andrological surgeries are also discussed. The authors emphasize the importance of international initiatives and the need for continued research to improve the management of male infertility.