{"doi":"10.1111/andr.13842","title":"From coffee to cocktails: Rethinking the limitations and future directions in men's beverage intake and fertility research","abstract":"Given data supporting accelerating reductions in sperm count globally1 and relations between sperm count and fertility, there is increasing concern regarding potential decrements in male fertility and a need to identify modifiable lifestyle factors that impact male fertility. Existing literature documents potential relations with many lifestyle factors, including conflicting findings between male beverage intake and male reproductive health.2-7 With men having high beverage intakes in many countries globally (e.g., Germany, Greece, Ireland, Spain, UK, USA),8 represents an accessible lever if causally related to male fertility. Salas-Huetos et al.9 recently published a manuscript investigating associations between male beverage intake, semen parameters, and assisted reproduction outcomes. With an appropriate timeframe for spermatogenesis between dietary intake and semen parameter assessment, their study9 overcomes the methodologic limit of cross-sectional study design used in the preponderance of prior literature on this topic, perhaps with the exception of studies examining alcohol intake and male reproductive function.6 Rather than limiting inquiry to a single class of beverages, the current report includes a thorough assessment of men's beverage intake. By including female partners without respect to fertility status, the authors report on, for lack of a non-causal term, the real-world effectiveness of these relations. The authors report an absence of relations between beverage intake and semen quality parameters. In contrast to prior studies,4, 5 there were also no documented relations between sugar and artificially sweetened beverages and male fertility. Amongst inconsistent and inconclusive existing evidence,2, 3 Salas-Huetos et al.9 report greater coffee/tea with caffeine in couples undergoing in vitro fertilization (IVF) and greater liquor intake associated with lower live birth probabilities in couples undergoing IVF, complimenting existing studies documenting impaired reproductive function among daily or high drinkers.6, 7 Salas-Huetos et al.9 have some key limitations that warrant consideration; the first is generalizability. Given that assisted reproduction, IVF-ICSI, in particular, can overcome poor semen quality, findings may not generalize to couples attempting unassisted conception. This may partially explain some conflicting findings relative to prior studies, such as the absence of relations between sugar and artificially sweetened beverages, which could also be at least partially because of the generally low levels of intake in the studied population (the 4th quartiles each began at less than a half serving per day). The sample size of the fertility outcomes analysis (n = 296) limits the study's power and options for exposure parameterization, with the use of halves, tertiles, and quantiles limiting the investigation of potential thresholds or “safe” levels of intake. For instance, there is some evidence of a non-linear relationship between male wine intake and live birth, whereby moderate levels of intake appear to be beneficial. Further, as an observational study, the study could be limited by unmeasured lifestyle and behavioral confounders, most notably female partner beverage intake, which would be expected to be correlated with both male beverage intake and fertility outcomes. While previously referenced as a novelty of this study, it should be emphasized that given the inclusion of female partners of unknown fertility status, the authors did not attempt to estimate the biological efficacy of these relations. Lastly, the estimates provided in Salas-Huetos et al.9 do not have causal interpretation, and there was no assessment of sperm DNA integrity, which could have provided insight into potential mechanisms for observed associations. While indeed a step forward regarding comprehensiveness, study design, and specificity to the assisted reproduction (ART) population, findings9 must be validated in other po","journal":"Andrology","year":2025,"id":560386,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9506,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":369130,"name":"Elizabeth A. DeVilbiss","orcid":"0000-0002-8840-0505","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-19T02:55:42.883572Z","pmid":"39812395","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}