Mary K Samplaski1, James F Smith2, Kirk C Lo3, James M Hotaling4, Susan Lau5, Ethan D Grober5, J C Trussell6, Thomas J Walsh7, Peter N Kolettis8, Victor D W Chow9, Armand S Zini10, Aaron Spitz11, Marc A Fischer12, Trustin Domes13, Scott I Zeitlin14, Eugene F Fuchs15, Jason C Hedges15, Jay I Sandlow16, Robert E Brannigan17, James M Dupree18, Marc Goldstein19, Edmund Y Ko20, Tung-Chin M Hsieh21, Jared M Bieniek22, David Shin23, Ajay K Nangia24, Keith A Jarvi25. 1. Institute of Urology, University of Southern California, Los Angeles, California. 2. Department of Urology, University of California, San Francisco, California. 3. Division of Urology, Department of Surgery, Mount Sinai Hospital and; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada. 4. Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah. 5. Division of Urology, Department of Surgery, Mount Sinai Hospital and. 6. Department of Urology, SUNY Upstate Medical University, Syracuse, New York. 7. Department of Urology, University of Washington, Seattle, Washington. 8. Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama. 9. Department of Urologic Science, University of British Columbia, Vancouver, British Columbia, Canada. 10. Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada. 11. Orange County Urology Associates, Laguna Hills, California. 12. Department of Surgery, McMaster University, Hamilton, Ontario, Canada. 13. Saskatoon Urology Associates, Saskatoon, Saskatchewan, Canada. 14. Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California. 15. Department of Urology, Oregon Health & Science University, Portland, Oregon. 16. Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin. 17. Department of Urology, Northwestern Medicine, Chicago, Illinois. 18. Department of Urology, University of Michigan, Ann Arbor, Michigan. 19. Department of Urology, Weill Cornell Medicine, New York, New York. 20. Department of Urology, Loma Linda University, Loma Linda, California. 21. Department of Urology, UC San Diego Health, La Jolla, California. 22. Tallwood Urology & Kidney Institute, Hartford HealthCare, Farmington, Connecticut. 23. Department of Urology, Hackensack University Medical Center, Hackensack, New Jersey. 24. Department of Urology Surgery, University of Kansas Health System, Kansas City, Kansas. 25. Division of Urology, Department of Surgery, Mount Sinai Hospital and; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada. Electronic address: keith.jarvi@sinaihealthsystem.ca.
Abstract
OBJECTIVE: To characterize the referral patterns and characteristics of men presenting for infertility evaluation using data obtained from the Andrology Research Consortium. DESIGN: Standardized male infertility questionnaire. SETTING: Male infertility centers. PATIENT(S): Men presenting for fertility evaluation. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Demographic, infertility history, and referral data. RESULT(S): The questionnaires were completed by 4,287 men, with a mean male age of 40 years ± 7.4 years and female partners age of 37 years ± 4.9 years. Most were Caucasian (54%) with other races being less commonly represented (Asian 18.6%, and African American 5.5%). The majority (59.7%) were referred by a reproductive gynecologist, 19.4% were referred by their primary care physician, 4.2% were self-referred, and 621 (14.5%) were referred by "other." Before the male infertility investigation, 12.1% of couples had undergone intrauterine insemination, and 4.9% of couples had undergone in vitro fertilization (up to six cycles). Among the male participants, 0.9% reported using finasteride (5α-reductase inhibitor) at a dose used for androgenic alopecia, and 1.6% reported exogenous testosterone use. CONCLUSION(S): This broad North American patient survey shows that reproductive gynecologists are the de facto gateway for most male infertility referrals, with most men being assessed in the male infertility service being referred by reproductive endocrinologists. Some of the couples with apparent male factor infertility are treated with assisted reproductive technologies before a male factor investigation. The survey also identified potentially reversible causes for the male infertility including lifestyle factors such as testosterone and 5α-reductase inhibitor use.
OBJECTIVE: To characterize the referral patterns and characteristics of men presenting for infertility evaluation using data obtained from the Andrology Research Consortium. DESIGN: Standardized male infertility questionnaire. SETTING:Male infertility centers. PATIENT(S): Men presenting for fertility evaluation. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Demographic, infertility history, and referral data. RESULT(S): The questionnaires were completed by 4,287 men, with a mean male age of 40 years ± 7.4 years and female partners age of 37 years ± 4.9 years. Most were Caucasian (54%) with other races being less commonly represented (Asian 18.6%, and African American 5.5%). The majority (59.7%) were referred by a reproductive gynecologist, 19.4% were referred by their primary care physician, 4.2% were self-referred, and 621 (14.5%) were referred by "other." Before the male infertility investigation, 12.1% of couples had undergone intrauterine insemination, and 4.9% of couples had undergone in vitro fertilization (up to six cycles). Among the male participants, 0.9% reported using finasteride (5α-reductase inhibitor) at a dose used for androgenic alopecia, and 1.6% reported exogenous testosterone use. CONCLUSION(S): This broad North American patient survey shows that reproductive gynecologists are the de facto gateway for most male infertility referrals, with most men being assessed in the male infertility service being referred by reproductive endocrinologists. Some of the couples with apparent male factor infertility are treated with assisted reproductive technologies before a male factor investigation. The survey also identified potentially reversible causes for the male infertility including lifestyle factors such as testosterone and 5α-reductase inhibitor use.
Authors: Amy Jewett; Lee Warner; Jennifer F Kawwass; Akanksha Mehta; Michael L Eisenberg; Ajay K Nangia; James M Dupree; Stanton Honig; James M Hotaling; Dmitry M Kissin Journal: F S Rep Date: 2022-03-25
Authors: Arighno Das; Anne Darves-Bornoz; Tejas Joshi; Mary Kate Keeter; James M Wren; Nelson E Bennett; Robert E Brannigan; Joshua A Halpern Journal: F S Rep Date: 2020-09-25