Dr. Goldstein: First report from the Andrology Research Consortium

First report from the Andrology Research Consortium

Introduction and Objectives 
While there are multi-center databases to capture information about the outcomes of in vitro fertilization (IVF) cycles, there is no such database for the causes and treatments for male infertility. In 2013 the Society for the Studies of Male Reproduction (SSMR) recognizing this gap, began support for the development of the Andrology Research Consortium (ARC), a multi-center collaboration developed to collect data from clinics dealing with male infertility. 

Methods 
Identical computer or paper based questionnaires to capture information about age, ethnic and racial background, infertility history, lifestyle factors of the couples and previous fertility therapies were completed by the men presenting to the clinic for the first time for a male infertility investigation. This data was then transferred to a central database for storage and analysis. 

Results 
A total of 14 centers specializing in male infertility across North America have contributed information on a total of 2108 patients. The mean duration of infertility was 3.3 +/- 3.7 years, with some centers reporting a much shorter duration of infertility of < 1.5 years. Overall 351/2040 (15.7%) men had contributed to a previous conception. Significant variability between centers was noted, with some reporting previous conceptions in over 25% of the men. Marijuana use was relatively common (260/2052: 12.7%) as was smoking (321/2061: 15.6%), but use of other drugs such as cocaine was uncommon. While the use of exogenous testosterone was just over 3% overall (63/1775: 3.5%), this varied between centres, with some centers reporting up to 10% usage. Just under 1% of the men reported using finasteride (17/2064: 0.82%). One or more IUI cycles had been performed for 305/1895 (16%) couples while IVF was performed with 152/1948 (7.8%) of the couples. Only 30/305 (9.8%) of the couples who had undergone an IUI cycle had a male factor evaluation prior to the IUI cycle and only 43/152 (28%) of the couples who had undergone an IVF cycle reported that they had a male factor evaluation prior to the IVF cycle. 

Conclusions 
Our study indicates that in North America, male factor infertility is often treated with the use of IUI or IVF, without any specialized investigation for the cause of the male infertility. Our study also shows that some reversible causes for the male infertility may be missed if a male infertility investigation is omitted. 

Co-authors:

Keith Jarvi*, Susan Lau, Kirk Lo, Ethan Grober, Toronto, Canada, James Hotaling, Salt Lake City, UT, Victor Chow, North Vancouver, Canada, Armand Zini, Montreal, Canada, Aaron Spitz, Laguna Hills, CA, Marc Anthony Fischer, Hamilton, Canada, Scott Zeitlin, Los Angeles, CA, Eugene Fuchs, Portland, OR, Mary Samplaski, Los Angeles, CA, Jay Sandlow, Milwaukee, WI, Robert Brannigan, Chicago, IL, Marc Goldstein, New York, NY, James Smith, San Francisco, CA, Edmund Ko, Loma Linda, CA