Results of a North American survey on the characteristics of men presenting for infertility investigations: The Andrology Research Consortium
The Andrology Research Consortium was established by the Society for the Study of Male Reproduction, a specialty section of the American Urological Association, to characterize men presenting for infertility investigations.
Men presenting for infertility investigation at a total of 24 North American subspecialty male infertility centers completed a standardized male infertility questionnaire.
Between May 2015 and Sept 2017, a total of 4335 men completed the questionnaires. The mean age of the men and their female partners was 37 (IQR 33-41) and 34 (IQR 31-40) years old, respectively. 74% (1537/2017) had not been previously assessed by a male fertility specialist. Intrauterine insemination (IUI) (99/1537) and IVF (164/1537) had been used to treat some of the couples who had never had a male factor infertility investigation. Potentially reversible causes for the male infertility included a previous vasectomy in 387/4335 (average duration since vasectomy of 10.5 years (IQR 5-14)) and medication/lifestyles factors. Cigarettes and marijuana were used by 470 (11%) and 411 (9.5%) of the men, respectively. Limited alcohol consumption (? 2 drinks/day) was common but only 6.4% reportedly drank > 2 drinks daily. Cocaine use was reported by 2% of the men. The reported frequency of use of testosterone and 5? reductase inhibitors (5ARIs) within the last 6 months varied by center with the lowest use being reported by the Toronto center. Excluding Toronto, 102/2071 (4.9%) and 87/2071 (4.2%) of the men reported using testosterone or 5ARIs, respectively. In Toronto, only 0.8% and 0.1% reported using testosterone or 5ARIs. The testosterone had been prescribed by urologists, endocrinologists and primary care physicians in almost equal numbers to manage low energy (31%), diminished libido (20%), for athletics and strength (15%) and other reasons. 8 men who reported taking testosterone also reported having gone through a previous IVF cycle.
This broad North American patient survey highlights that many couples with male factor infertility are being treated with IUI or IVF prior to the men being fully investigated. The survey also identified potentially reversible causes for the male infertility including lifestyle factors and the common use of testosterone and 5ARIs
Funding: Society for the Study of Male Reproduction