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Male subfertility is a very significant global problem. Epidemiological data show that approximately one in seven couples are classified as subfertile [1]. Sperm dysfunction is the single most common cause of male subfertility. An older study employing a sperm concentration cut-off of <20 × 106/ml found that 20%of 18- year-old men were classed as subfertile [2]. Although it is too simplistic to base a classification of subfertility solely on sperm concentration, the reported frequency of male subfertility points to a high proportion of the population being affected, compared with other prevalent diseases such as diabetes. What is more worrying is the likelihood that sperm counts are falling and the prevalence of male subfertility is increasing [3,4].Moreover, male fertility has been shown to be a barometer of overall health and longevity [5–7], and significant evidence suggests that the health of future generations may be influenced epigenetically by the quality of their father’s spermatozoa, which may have been altered by his diet and/or lifestyle [8–10]; perhaps such effects underlie the fall in sperm counts [4]. In addition, there are many substances and products that are toxic to spermatozoa in our everyday environment [11]. Unfortunately, little progress has been made towards answering fundamental questions in andrology or in developing new diagnostic tools or alternative management strategies for infertile men other than ICSI [12,13]. A recent expert meeting highlighted evidence gaps and important research areas, and proposed a strategic approach whereby andrology might make the rapid progress necessary to address key scientific, clinical, and societal challenges that face our discipline [14]. Andrology is therefore a pivotal discipline in modern medicine, and it is against this background that we have updated this handbook.