Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
ECRI, Plymouth Meeting, Pennsylvania.
J Urol. 2024 Dec;212(6):789-799. doi: 10.1097/JU.0000000000004180. Epub 2024 Aug 15.
In 2023 the American Urological Association (AUA) requested an Update Literature Review (ULR) to incorporate new evidence generated since the 2020 publication of this Guideline. The resulting 2024 Guideline Amendment addresses updated recommendations to provide guidance on the appropriate evaluation and management of the male partner in an infertile couple.
In 2023, the Male Infertility Guideline was updated through the AUA amendment process in which newly published literature is reviewed and integrated into previously published guidelines. An updated literature search identified 4093 new abstracts. Following initial abstract screening, 125 eligible study abstracts met inclusion criteria. On data extraction, 22 studies of interest were included in the final evidence base to inform the Guideline amendment.
The Panel developed evidence- and consensus-based statements based on an updated review to provide guidance on evaluation and management of male infertility. These updates are detailed herein.
This update provides several new insights, including revised thresholds for Y-chromosome microdeletion testing, indications for pelvic magnetic resonance imaging (MRI) imaging in infertile males, and guidance regarding the use of testicular sperm in nonazoospermic males. This Guideline will require further review as the diagnostic and treatment options in this space continue to evolve.
2023 年，美国泌尿外科学会（AUA）要求进行更新文献综述（ULR），以纳入自 2020 年该指南发表以来产生的新证据。由此产生的 2024 年指南修正案针对更新的建议进行了处理，旨在为不育夫妇中男性伴侣的适当评估和管理提供指导。
2023 年，通过 AUA 修正案程序对男性不育指南进行了更新，其中对新发表的文献进行了审查并纳入了以前发表的指南。新的文献检索确定了 4093 篇新的摘要。在初步摘要筛选后，有 125 篇符合条件的研究摘要符合纳入标准。在数据提取过程中，有 22 项相关研究被纳入最终的证据基础，为指南修正案提供信息。
专家组根据更新后的综述制定了基于证据和共识的声明，以提供男性不育评估和管理的指导。这些更新内容在此详细介绍。
本次更新提供了一些新的见解，包括 Y 染色体微缺失检测的阈值修订、不育男性盆腔磁共振成像（MRI）检查的适应证，以及关于非无精子症男性睾丸精子使用的指导。随着该领域的诊断和治疗选择不断发展，本指南将需要进一步审查。
