BERKELEY, CA (UroToday.com) - Significant social and demographic shifts in the United States, combined with improved in vitro fertilization (IVF) techniques, have led to increased interest in and utilization of assisted reproductive technology (ART). Survey-based measures of the prevalence of male infertility have shown that 7.5% of men in the U.S. report seeking help for infertility, and of those that sought care, 18.1% reported clinician-diagnosed male-related infertility. However, little is known about the geographic distribution of a male factor infertility diagnosis in the United States at the national and regional levels or how these have changed over time. By using data from all ART cycles performed in U.S. fertility clinics published by the Centers for Disease Control and Prevention (CDC), we were able to geocode and map the rates of male infertility diagnoses at ART clinics and uncover very interesting trends.
Nationwide in ART clinics, the period prevalence of isolated male factor infertility was 17.1% and the prevalence of overall male factor infertility diagnoses was 34.6%. State-level analysis revealed high variability in isolated male factor infertility diagnoses. Utah (26.9%), Minnesota (25.4%), Wisconsin (24.6%), New Hampshire (24.2%), and Vermont (23.2%) had the highest proportion of isolated male infertility diagnosed at ART clinics, while Alabama (10.3%), Mississippi (11.3%), West Virginia (11.9%), Georgia (12.3%), and New Mexico (12.6%) had the lowest prevalence. Temporally, there was a distinct dispersion in the reported prevalence of male infertility, despite stable means.
There are many factors associated with male infertility, such as obesity, prostate and testicular cancer, and environmental factors. Although none of these associations has been explored spatially at the national level, these spatial analytic tools can be used to define the extent and variation of male infertility presenting to ART centers and to define possible changes and hotspots over time. Overall, we found that the prevalence of male infertility diagnosis varied significantly by time and space within the US while its overall prevalence has remained remarkably stable.
This study provides the spatial analytic framework for future research to explore factors associated with male factor infertility.
Anobel Y. Odisho, MD, MPHa and James F. Smith, MD, MSa, b as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
a Department of Urology, University of California, San Francisco, San Francisco, CA USA
b Department of Obstetrics, Gynecology, and Reproductive Sciences and Institute for Health Policy, University of California, San Francisco, CA USA