Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
Clin Endocrinol (Oxf). 2024 Jun;100(6):565-574. doi: 10.1111/cen.15059. Epub 2024 Apr 12.
Idiopathic male infertility is common, yet there is no approved treatment. This study aimed to understand practice patterns towards empirical medical therapy (EMT) for idiopathic male infertility in Australia and New Zealand (NZ).
Clinical members of the Endocrine Society of Australia, Fertility Society of Australia & NZ, and Urological Society of Australia & NZ were invited to complete a survey. Questions included demographics, EMT practice habits, and thoughts regarding infertility case scenarios. Unadjusted group differences between specialists, those with and without additional training in male infertility, and frequency of managing it were evaluated.
Overall, 147 of 2340 members participated (6.3%); majority were endocrinologists and gynaecologists. Participants were experienced; 35% had completed additional training in male infertility and 36.2% reported they frequently manage male infertility. Gynaecologists were more likely to manage male infertility and attend education courses than endocrinologists and urologists. Beliefs about the effect of EMT on sperm concentration and pregnancy did not differ between speciality types. Many respondents considered all patient scenarios suitable for EMT. Of medications, hCG and clomiphene were selected most. Two respondents indicated they would use testosterone to treat male infertility.
This study demonstrates common use of EMT in Australia and NZ for idiopathic male infertility. The breadth of responses reflects a lack of consensus within the current literature, highlighting the need for further research to clarify their role in the management of idiopathic male infertility.
特发性男性不育症较为常见,但目前尚无获批的治疗方法。本研究旨在了解澳大利亚和新西兰(NZ)针对特发性男性不育症采用经验性医学治疗(EMT)的实践模式。
内分泌学会、澳大利亚和新西兰生育学会以及澳大利亚和新西兰泌尿学会的临床成员受邀参与了这项调查。问题包括人口统计学、EMT 实践习惯以及对不育病例情况的看法。评估了专家之间、有或没有男性不育额外培训的人之间以及管理男性不育频率的差异。
共有 2340 名成员中的 147 名(6.3%)参与了这项研究;大多数是内分泌学家和妇科医生。参与者经验丰富;35%的人完成了男性不育额外培训,36.2%的人报告说他们经常管理男性不育。妇科医生比内分泌医生和泌尿科医生更有可能管理男性不育并参加教育课程。关于 EMT 对精子浓度和妊娠的影响的信念在专业类型之间没有差异。许多受访者认为所有患者情况都适合 EMT。在药物方面,选择 hCG 和克罗米酚的比例最高。有两名受访者表示他们将使用睾酮治疗男性不育。
本研究表明 EMT 在澳大利亚和 NZ 被广泛用于治疗特发性男性不育症。广泛的反应反映了目前文献中缺乏共识,这突出表明需要进一步研究来阐明 EMT 在特发性男性不育症管理中的作用。