Introduction

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 investigation.

Methods

A standardized questionnaire capturing information about the infertile couples' demographics, reproductive history, previous fertility investigations, lifestyle factors and use of medications was completed by patients in 19 different clinics treating men with infertility across North America.

Results

A total of 2506 men completed the questionnaires. The mean age of the men and their female partners was 38 +/- 7 (SD) and 34 +/- 5 years old, respectively. 1505/2421 (62%) were referred by a reproductive endocrinologist and 524/2421 (22%) by their PCP. Of the 812 who answered this question, 688 (85%) reported that they were told that they had an abnormal sperm test. _x000D_ Prior to the consultation with the male infertility clinic, 274/2023 (14%) reported having used Intra-uterine insemination (IUI) with another 168/2168 (7.7%) reported the use of in-vitro fertilization (IVF) or intracytoplasmic sperm insertion (ICSI) therapy to treat the infertility. Only 31/274 (11%) of the couples who had undergone IUIs and 17/168 (10%) of those using IVF/ICSI reported a previous male fertility investigation. _x000D_ Potentially reversible causes of male infertility like use of medications and smoking were relatively common. Overall, 35/2384 (1.5%) men reporting using propecia and 74/2218 (3.3%) using testosterone. This data was skewed by the results from the University of Toronto where patients reported far lower use of propecia (1/1274) or testosterone (7/1274). Excluding the University of Toronto results, 34/1110 (3.1%) and 67/944 (7.1%) of the men reported using propecia and/or testosterone, respectively. While uncommon, 2 men reported that they had used IUI or IVF while remaining on propecia or testosterone. The testosterone was prescribed principally by PCPs, but many of the men reported that they obtained testosterone from non-physicians. In total, 352/2034 (17.3%) reported smoking.

Conclusions

Most men presenting to our male infertility clinics are referred from reproductive endocrinologists with abnormal sperm test results. Among couples who had previously been treated with advanced reproductive technologies like IUI, IVF or ICSI, only 11% had been referred to a urologist prior to the therapies. We identified a number of potentially reversible causes for the male sub-fertility in this group supporting the idea that more urology is needed, not less.

Funding

Society for the Study of Male Reproduction