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.

Autor:	Samplaski MK; Institute of Urology, University of Southern California, Los Angeles, California., Smith JF; Department of Urology, University of California, San Francisco, California., Lo KC; Division of Urology, Department of Surgery, Mount Sinai Hospital and; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada., Hotaling JM; Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah., Lau S; Division of Urology, Department of Surgery, Mount Sinai Hospital and., Grober ED; Division of Urology, Department of Surgery, Mount Sinai Hospital and., Trussell JC; Department of Urology, SUNY Upstate Medical University, Syracuse, New York., Walsh TJ; Department of Urology, University of Washington, Seattle, Washington., Kolettis PN; Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama., Chow VDW; Department of Urologic Science, University of British Columbia, Vancouver, British Columbia, Canada., Zini AS; Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada., Spitz A; Orange County Urology Associates, Laguna Hills, California., Fischer MA; Department of Surgery, McMaster University, Hamilton, Ontario, Canada., Domes T; Saskatoon Urology Associates, Saskatoon, Saskatchewan, Canada., Zeitlin SI; Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California., Fuchs EF; Department of Urology, Oregon Health & Science University, Portland, Oregon., Hedges JC; Department of Urology, Oregon Health & Science University, Portland, Oregon., Sandlow JI; Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin., Brannigan RE; Department of Urology, Northwestern Medicine, Chicago, Illinois., Dupree JM; Department of Urology, University of Michigan, Ann Arbor, Michigan., Goldstein M; Department of Urology, Weill Cornell Medicine, New York, New York., Ko EY; Department of Urology, Loma Linda University, Loma Linda, California., Hsieh TM; Department of Urology, UC San Diego Health, La Jolla, California., Bieniek JM; Tallwood Urology & Kidney Institute, Hartford HealthCare, Farmington, Connecticut., Shin D; Department of Urology, Hackensack University Medical Center, Hackensack, New Jersey., Nangia AK; Department of Urology Surgery, University of Kansas Health System, Kansas City, Kansas., Jarvi KA; 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.
Jazyk:	angličtina
Zdroj:	Fertility and sterility [Fertil Steril] 2019 Oct; Vol. 112 (4), pp. 657-662. Date of Electronic Publication: 2019 Jul 24.
DOI:	10.1016/j.fertnstert.2019.06.011
Abstrakt:	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. (Copyright © 2019 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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