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Direct fertility and live\u2010birth data remain sparse. Trial registries include more male reproductive endpoints than published studies report. Regulatory labels mainly inform genital\u2010safety counseling and nonclinical reproductive toxicology language. Patents contain erectile and male reproductive claims, but these claims are not clinical evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusion<\/jats:title>\n                    <jats:p>Counseling should separate genital safety, endocrine and sexual\u2010function signals, semen and fertility outcomes, and paternal\u2010exposure concerns. Hormonal, sexual\u2010function, or semen changes may track metabolic recovery; they do not establish improved conception or live birth. These drugs should be selected for metabolic indications, not as treatments for ED or infertility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.70366","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T07:02:16Z","timestamp":1787900536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Male Sexual and Reproductive Health in Diabetes and Obesity Pharmacotherapy: A Source\u2010Triangulated Counseling Map"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5652-1652","authenticated-orcid":false,"given":"Marek","family":"Broul","sequence":"first","affiliation":[{"name":"Department of Sexology Krajsk\u00e1 Zdravotn\u00ed a.s.\u2013Masaryk Hospital in \u00dast\u00ed nad Labem, o.z.  \u00dast\u00ed nad Labem Czech Republic"},{"name":"Department of Urology Krajsk\u00e1 Zdravotn\u00ed a.s.\u2013Litom\u011b\u0159ice Hospital, o.z.  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