Thaker Hatim, Ko Edmund Y, Sabanegh Edmund S, Brannigan Robert E, Alukal Joseph P, Samplaski Mary K
Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Urology, Loma Linda University, Loma Linda, California.
F S Rep. 2020 Apr 25;1(1):15-20. doi: 10.1016/j.xfre.2020.04.003. eCollection 2020 Jun.
To determine if there has been a change in empirical medical therapy (EMT) practices since a 2010 American Urological Association survey reported that 25% of urologists treated infertile men who were pursuing a pregnancy with testosterone (T).
Survey-based cohort study of AUA members.
Practice patterns were evaluated of urologists in academic and nonacademic hospital centers.
Practice patterns were evaluated in the treatment of men with idiopathic infertility.
None.
Subgroup analysis by means of univariate analysis between means (Fisher exact test) and descriptive proportions was used to compare male infertility fellowship-trained urologists (RUs) to general urologists (non-RUs).
A total of 191 urologists responded (4.7%). Excluding trainees, 164 responses (85.9%) were analyzed: 134 (82.3%) were from non-RUs and 29 from (17.7%) RUs. Over all, 65.9% treated male infertility with a combination of EMT and surgery (93.1% of RU vs. 60.4% of non-RUs). The most common medications used by RUs were clomiphene (100%), anastrozole (85.7%), and hCG/LH (82.1%). Non-RUs used these less frequently. Overall, 24.4% of the urologists reported that they would use T to treat male infertility: 14.4% (n = 4) of RUs and 24.4% (n = 30) of non-RUs.
A total of 65.9% of urologists would treat male infertility with the use of EMT and surgery. The most common EMTs were clomiphene, anastrozole, and hCG/LH. Of concern, 24.4% of urologists considered T to treat male infertility, a medication with known contraceptive potential. This is unchanged from the 2010 survey, and confirms the need for reproductive medicine guidelines that include the topic of EMT use in infertile men.
自2010年美国泌尿外科学会调查显示25%的泌尿科医生会用睾酮（T）治疗正在备孕的不育男性以来，确定经验性医学治疗（EMT）的做法是否发生了变化。
基于调查的美国泌尿外科学会成员队列研究。
对学术和非学术医院中心的泌尿科医生的执业模式进行评估。
对特发性不育男性的治疗执业模式进行评估。
无。
采用均值间单因素分析（Fisher精确检验）和描述性比例进行亚组分析，以比较接受男性不育专科培训的泌尿科医生（RU）和普通泌尿科医生（非RU）。
共有191名泌尿科医生回复（回复率4.7%）。排除实习生后，分析了164份回复（85.9%）：134份（82.3%）来自非RU，29份（17.7%）来自RU。总体而言，65.9%的医生采用EMT和手术联合治疗男性不育（RU中为93.1%，非RU中为60.4%）。RU最常用的药物是克罗米芬（100%）、阿那曲唑（85.7%）和人绒毛膜促性腺激素/促黄体生成素（hCG/LH，82.1%）。非RU使用这些药物的频率较低。总体而言，24.4%的泌尿科医生报告他们会用T治疗男性不育：RU中有14.4%（n = 4），非RU中有24.4%（n = 30）。
共有65.9%的泌尿科医生会采用EMT和手术治疗男性不育。最常用的EMT药物是克罗米芬、阿那曲唑和hCG/LH。令人担忧的是，24.4%的泌尿科医生考虑用T治疗男性不育，而T是一种已知有避孕作用的药物。这与2010年的调查结果没有变化，证实了需要制定包括不育男性EMT使用主题的生殖医学指南。
