WELFARE

Infertility is a pathological condition of the reproductive system characterised by the absence of clinical pregnancy after 12 months or more of regular, unprotected sexual intercourse. As an impairment of a body function, it can be considered as a disability. It affects 8-15% of couples of childbearing age and in about 50% of cases, the origin is male, justifying a systematic exploration of the man. The quantitative and qualitative biological analysis of the semen is the cornerstone of this exploration but remains insufficient to identify the cause or aetiology of the infertility. The aetiological diagnosis of male infertility is difficult and requires a structured approach, numerous and sometimes complex tests as well as experienced practitioners. This diagnosis is difficult but essential to offer the couple, and the unborn child, the most appropriate treatment for their safety, health and well-being. The exploration and treatment of male infertility is a medical speciality: andrology. The experts are warning of two shortcomings of the specialty that feed each other in a vicious circle: the first is linked to insufficient supply of care (lack of practitioners, reduced availability and longer delays for specialised examinations) and the second is linked to poor clinical research. Several causes have been identified, including the lack of sufficient data collected from infertile men and their incomplete classification/stratification. The answer to this double gap lies in the constitution of a rich database and the use numerical models for patient stratification. The European call for proposals HORIZON-HLTH-2022-TOOL-12-01-two-stage (Computational models for new patient stratification strategies) is an excellent opportunity to develop these tools. We designed the WELFARE project to respond to this call with the main objectives of creating a centralised infrastructure for collecting andrological data from various sources and developing digital stratification tools using artificial intelligence and advanced statistics. Two main ideas concerning data collection organize the project structure: to focus on southern European countries for which there is a significant deficit of andrological data, to integrate data from adult infertile men but also from boys with male genital tract anomalies. This combination between adult and child data and the longitudinal view it gives to the physiopathology constitute a breakthrough in andrology. For this project, 8 clinical teams from 4 countries (Italy, France, Spain and Portugal) will be recruited. In each country, The selection of an andrology team and a paediatric surgery teams is based on their experience in clinical research and their international recognition. This is the first time that so many teams from the two specialities will share their data. This will provide to the network a very high level of complementarity and scientific relevance. The consortium will also include teams specialised in clinical research, multi-source database creation, statistics and artificial intelligence as well as human sciences, and will be supervised by an independent scientific advisory board. The impact of this ambitious interdisciplinary project is significant. Through the database and the models that it will set up, it will contribute to re-establishing a virtuous circle between andrological care and research in the 4 southern European countries involved.