One size does not fit all: variations by ethnicity in demographic characteristics of men seeking fertility treatment across North America

Racial differences exist for males undergoing urologist fertility evaluation. Understanding these and societal and biologic factors can guide personalized care and help address disparities in access to male fertility care.

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VOLUME 116, ISSUE 5, P1287-1294

Authors:

Andrew B. Chen, M.D., Keith A. Jarvi, M.D., Katherine Lajkosz, M.Sc., James F. Smith, M.D., Kirk C. Lo, M.D., Ethan D. Grober, M.D., Susan Lau, B.Sc., Jared M. Bieniek, M.D., Robert E. Brannigan, M.D., Victor D.W. Chow, M.D., Trustin Domes, M.D., James M. Dupree, M.D., Marc Goldstein, M.D., Jason C. Hedges, M.D., Ph.D., James M. Hotaling, M.D., Edmund Y. Ko, M.D., Peter N. Kolettis, M.D., Ajay K. Nangia, M.B.B.S., Jay I. Sandlow, M.D., David Shin, M.D., Aaron Spitz, M.D., J.C. Trussell, M.D., Scott I. Zeitlin, M.D., Armand S. Zini, M.D., Marc A. Fisher, M.D., Thomas J. Walsh, M.D., Tung-Chin M. Hsieh, M.D., Eugene F. Fuchs, M.D., Mary K. Samplaski, M.D. 

Abstract:

Objective

To compare racial differences in male fertility history and treatment.


Design

Retrospective review of prospectively collected data.


Setting

North American reproductive urology centers.


Patient(s)

Males undergoing urologist fertility evaluation.


Intervention(s)

None.


Main Outcome Measure(s)

Demographic and reproductive Andrology Research Consortium data.


Result(s)

The racial breakdown of 6,462 men was: 51% White, 20% Asian/Indo-Canadian/Indo-American, 6% Black, 1% Indian/Native, <1% Native Hawaiian/Other Pacific Islander, and 21% “Other”. White males sought evaluation sooner (3.5 ± 4.7 vs. 3.8 ± 4.2 years), had older partners (33.3 ± 4.9 vs. 32.9 ± 5.2 years), and more had undergone vasectomy (8.4% vs. 2.9%) vs. all other races. Black males were older (38.0 ± 8.1 vs. 36.5 ± 7.4 years), sought fertility evaluation later (4.8 ± 5.1 vs. 3.6 ± 4.4 years), fewer had undergone vasectomy (3.3% vs. 5.9%), and fewer had partners who underwent intrauterine insemination (8.2% vs. 12.6%) compared with all other races. Asian/Indo-Canadian/Indo-American patients were younger (36.1 ± 7.2 vs. 36.7 ± 7.6 years), fewer had undergone vasectomy (1.2% vs. 6.9%), and more had partners who underwent intrauterine insemination (14.2% vs. 11.9%). Indian/Native males sought evaluation later (5.1 ± 6.8 vs. 3.6 ± 4.4 years) and more had undergone vasectomy (13.4% vs. 5.7%).


Conclusion(s)

Racial differences exist for males undergoing fertility evaluation by a reproductive urologist. Better understanding of these differences in history in conjunction with societal and biologic factors can guide personalized care, as well as help to better understand and address disparities in access to fertility evaluation and treatment.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.