ADGB (androglobin) is a chimeric globin family member with a circularly permutated globin domain and calpain domain that binds heme through a bis-histidyl hexacoordinate iron center, enabling interactions with dioxygen, carbon monoxide, and nitric oxide. Its primary physiological role centers on male fertility: ADGB is essential for sperm flagellum formation and spermatid maturation, and pathogenic variants cause asthenozoospermia and male infertility through defects in flagella and acrosome development 1. ADGB expression is tightly regulated by FOXJ1-dependent transcriptional mechanisms and associates with ciliogenesis, being predominantly expressed in tissues with motile cilia and flagella, including testis, female reproductive tract, lungs, and brain 2. Beyond its ciliogenic functions, ADGB interacts with multiple spermatogenesis proteins including CFAP69 and SPEF2 1. Recent evidence suggests ADGB may have context-dependent roles in cancer biology: while in vitro studies in lung cancer cells indicate potential oncogenic effects via increased cell motility and extracellular matrix remodeling 3, ADGB expression is typically downregulated in human tumors, limiting its in vivo tumorigenic significance 3. Intracytoplasmic sperm injection (ICSI) enables successful fertilization in ADGB-deficient patients, offering a targeted reproductive strategy for affected males 4.