Reproductive endocrinologists are the gatekeepers for male infertility care in North America: results of a North American survey on the referral patterns and characteristics of men presenting to male infertility specialists for infertility investigations. Fertil Steril 2019 Oct;112(4):657-662
Date
07/29/2019Pubmed ID
31351700DOI
10.1016/j.fertnstert.2019.06.011Scopus ID
2-s2.0-85069678264 (requires institutional sign-in at Scopus site) 27 CitationsAbstract
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.
Author List
Samplaski MK, Smith JF, Lo KC, Hotaling JM, Lau S, Grober ED, Trussell JC, Walsh TJ, Kolettis PN, Chow VDW, Zini AS, Spitz A, Fischer MA, Domes T, Zeitlin SI, Fuchs EF, Hedges JC, Sandlow JI, Brannigan RE, Dupree JM, Goldstein M, Ko EY, Hsieh TM, Bieniek JM, Shin D, Nangia AK, Jarvi KAAuthor
Jay I. Sandlow MD Chair, Professor in the Urologic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultEndocrinologists
Female
Humans
Infertility, Male
Male
Middle Aged
Referral and Consultation
Reproductive Techniques, Assisted
Surveys and Questionnaires
