Al Khayal Abdullah M, Balaraj Faisal K, Alferayan Turki A, Al Sait Mutaz A, Abumelha Saad M, Alrabeeah Khalid A
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Department of Surgery, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Urol Ann. 2021 Oct-Dec;13(4):346-350. doi: 10.4103/UA.UA_22_20. Epub 2021 Jun 23.
Empirical therapy is sometimes used by urologists who desire to improve the outcomes for infertility patients. However, the literature on empirical therapies is scarce. Therefore, we aimed to assess the clinical practice of urologists regarding the use of empirical therapy in the treatment of infertility patients.
An online survey using Google Forms was used to collect data during the Saudi Urological Association Annual Meeting, February 2019. Additional data were gathered electronically in March and April 2019 and sent to respondents. The study was closed in May 2019. No incentives were provided to the respondents.
A total of 96 (80%) urologists participated in the survey, of whom 69.8% were consultants, and 20.8% were andrology-trained urologists. Empirical therapy was used by 86.5% of urologists for patients with idiopathic oligoasthenoteratozoospermia. The most commonly used empirical therapies were zinc, L-canitine, clomiphene citrate, and L-arginine. The main factors that influenced the selection of empirical therapy were follicle-stimulating hormone, total testosterone, and luteinizing hormone levels.
Empirical therapy was used by more than three-quarters of the participants for idiopathic male infertility. There were no clear guidelines for the ideal therapy to be considered for individual patients while treating empirically. Our concern is that urologists use a wide variety of medications without significant data to support these medications.
一些泌尿科医生有时会采用经验性疗法来改善不育症患者的治疗效果。然而，关于经验性疗法的文献却很匮乏。因此，我们旨在评估泌尿科医生在治疗不育症患者时使用经验性疗法的临床实践情况。
在2019年2月沙特阿拉伯泌尿外科学会年会上，通过谷歌表单进行了一项在线调查以收集数据。2019年3月和4月又以电子方式收集了更多数据并发送给受访者。该研究于2019年5月结束。未向受访者提供任何激励措施。
共有96名（80%）泌尿科医生参与了调查，其中69.8%为顾问医生，20.8%为接受过男科学培训的泌尿科医生。86.5%的泌尿科医生对特发性少弱畸精子症患者采用了经验性疗法。最常用的经验性疗法是锌、左旋肉碱、枸橼酸氯米芬和L-精氨酸。影响经验性疗法选择的主要因素是促卵泡生成素、总睾酮和促黄体生成素水平。
超过四分之三的参与者对特发性男性不育症采用了经验性疗法。在进行经验性治疗时，对于个体患者应考虑何种理想疗法尚无明确指南。我们担心的是，泌尿科医生在没有大量数据支持的情况下使用了各种各样的药物。
