Department of Urology, University of Miami, Miami, Florida, USA.
Curr Opin Urol. 2019 May;29(3):267-271. doi: 10.1097/MOU.0000000000000590.
We aim to provide a review of the literature to summarize the potential causes that lead to a disparity in infertility evaluation and the implications of male factor infertility.
Owing to current social constructs, women are more likely to seek medical attention and establish reproductive health evaluation at an earlier age. The male factor evaluation in infertility usually gets delayed and can contribute to a couple's inability to conceive. Furthermore, the cost of assisted reproductive technology is not inconsequential and identifying reversible causes of male infertility could lead to substantial cost-savings to the couple. Additionally, male infertility has been identified as a potential early surrogate for adverse health outcomes and an early identification could serve to counsel these patients on lifestyle modification.
Infertility is defined as the inability to conceive after 12 months of unprotected intercourse with 15% of couples reporting difficulties in conception. Traditionally, female factor evaluation has been the driver for the infertility workup. It is estimated that male factor is likely to play a role in 50% of infertile couples with sole contribution in 20% of cases. It is therefore crucial to ensure appropriate investigations of both partners to rule out potentially reversible causes of infertility to improve their chances of natural fecundity.
我们旨在对文献进行综述，总结导致不孕评估差异的潜在原因以及男性因素不孕的影响。
由于当前的社会结构，女性更有可能寻求医疗关注并在更早的年龄进行生殖健康评估。不孕不育的男性因素评估通常会延迟，这可能导致夫妇无法怀孕。此外，辅助生殖技术的成本并不小，确定男性不育的可逆原因可能会为夫妇节省大量成本。此外，男性不育已被确定为不良健康结果的潜在早期替代指标，早期识别可以为这些患者提供关于生活方式改变的咨询。
不孕定义为在无保护性行为 12 个月后仍无法怀孕，15%的夫妇报告受孕困难。传统上，女性因素评估一直是不孕检查的驱动因素。据估计，男性因素可能在 50%的不孕夫妇中起作用，而在 20%的病例中则是唯一的原因。因此，确保对双方进行适当的检查以排除潜在的可逆转的不孕原因至关重要，这可以提高他们自然生育的机会。
