Giuseppe Fallara1,2, Walter Cazzaniga1,2, Luca Boeri1,3, Paolo Capogrosso1,4, Luigi Candela1,2, Edoardo Pozzi1, Federico Belladelli1,5, Nicolò Schifano1,2, Eugenio Ventimiglia1, Costantino Abbate1, Enrico Papaleo5,6, Paola Viganò5,6, Francesco Montorsi1,2, Andrea Salonia1,2. 1. Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. 2. University Vita-Salute San Raffaele, Milan, Italy. 3. Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. 4. Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy. 5. Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy. 6. Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy.
Abstract
BACKGROUND: Trends of male factor causes of couples' infertility over time have been poorly investigated. OBJECTIVE: We investigated trends in the causes of pure male factor infertility (MFI) throughout the last 10 years in a tertiary-referral academic andrology center. MATERIAL AND METHODS: Baseline characteristics at first presentation from a cohort of 1647 consecutive male factor infertility patients belonging to primary infertile couples between 2008 and 2018 have been comprehensively collected over time. Seven major causes of male factor infertility were identified: varicocoele; history of cryptorchidism; hypogonadism (primary and secondary); obstructive azoospermia; genetic abnormalities; other causes (large group including the remnant conditions of known causes); and idiopathic infertility. Rates of different male factor infertility causes over the study period were analyzed. Multivariable logistic regression models tested the likelihood of male factor infertility causes over time. Estimated trends were explored graphically. RESULTS: Of all, varicocoele was found in 615 (37.3%), cryptorchidism in 124 (7.5%), genetic abnormalities in 61 (3.7%), hypogonadism in 165 (10%), obstructive conditions in 55 (3.3%), other causes in 129 (7.8%) patients, and idiopathic infertility in 498 (30.3%) patients, respectively. Over time, a reduction in the proportions of cryptorchidism and varicocoele (all P < 0.001) cases was observed, along with an increase in the proportions of hypogonadism, other causes of MFI and idiopathic cases (all P ≤ 0.01). Rates of genetic and obstructive cases remained stable. The observed trends were confirmed at logistic regression models. DISCUSSION AND CONCLUSIONS: A decreasing trend in the proportions of varicocoele and cryptorchidism at first presentation was observed over the last 10 years; conversely, the proportions of idiopathic cases, hypogonadal patients, and infertile men presenting with other male factor infertility causes significantly increased over the same time frame at a single tertiary-referral academic andrology center.
BACKGROUND: Trends of male factor causes of couples' infertility over time have been poorly investigated. OBJECTIVE: We investigated trends in the causes of pure male factor infertility (MFI) throughout the last 10 years in a tertiary-referral academic andrology center. MATERIAL AND METHODS: Baseline characteristics at first presentation from a cohort of 1647 consecutive male factor infertilitypatients belonging to primary infertile couples between 2008 and 2018 have been comprehensively collected over time. Seven major causes of male factor infertility were identified: varicocoele; history of cryptorchidism; hypogonadism (primary and secondary); obstructive azoospermia; genetic abnormalities; other causes (large group including the remnant conditions of known causes); and idiopathic infertility. Rates of different male factor infertility causes over the study period were analyzed. Multivariable logistic regression models tested the likelihood of male factor infertility causes over time. Estimated trends were explored graphically. RESULTS: Of all, varicocoele was found in 615 (37.3%), cryptorchidism in 124 (7.5%), genetic abnormalities in 61 (3.7%), hypogonadism in 165 (10%), obstructive conditions in 55 (3.3%), other causes in 129 (7.8%) patients, and idiopathic infertility in 498 (30.3%) patients, respectively. Over time, a reduction in the proportions of cryptorchidism and varicocoele (all P < 0.001) cases was observed, along with an increase in the proportions of hypogonadism, other causes of MFI and idiopathic cases (all P ≤ 0.01). Rates of genetic and obstructive cases remained stable. The observed trends were confirmed at logistic regression models. DISCUSSION AND CONCLUSIONS: A decreasing trend in the proportions of varicocoele and cryptorchidism at first presentation was observed over the last 10 years; conversely, the proportions of idiopathic cases, hypogonadal patients, and infertilemen presenting with other male factor infertility causes significantly increased over the same time frame at a single tertiary-referral academic andrology center.
Authors: Athina C Tsili; Loukas G Astrakas; Anna C Goussia; Nikolaos Sofikitis; Maria I Argyropoulou Journal: Eur Radiol Date: 2022-04-29 Impact factor: 5.315
Authors: A Ferlin; A E Calogero; C Krausz; F Lombardo; D Paoli; R Rago; C Scarica; M Simoni; C Foresta; V Rochira; E Sbardella; S Francavilla; G Corona Journal: J Endocrinol Invest Date: 2022-01-24 Impact factor: 4.256