Male accessory gland infection (MAGI): Over-diagnosed or under treated in infertile men?

Male accessory gland infection (MAGI) is a significant yet often under-recognized contributor to male infertility. This review article provides a comprehensive synopsis of MAGI, distinguishing it from male genital tract infection (MGTI) and emphasizing the challenges posed by asymptomatic cases. It concisely presents the pathophysiology of MAGI, highlighting the inflammatory response characterized by leukocyte infiltration, elevated pro-inflammatory cytokines, and increased production of reactive oxygen species, which collectively impair sperm quality and fertilizing capability. The article discusses the complexities in diagnosis due to the overlap with benign conditions and presents emerging diagnostic markers. It also critically reviews the controversies surrounding the over-diagnosis and under-treatment of MAGI, emphasizing the need for improved diagnostic accuracy to encourage appropriate treatment. Current therapeutic strategies are explored, revealing variable efficacy and the importance of personalized approaches. This review aims to provide a clear understanding of the clinical implications of MAGI and to guide accurate diagnosis and effective treatment, ensuring better fertility outcomes for affected patients.