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Infertility in Males01:23

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Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
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Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
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Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although...
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Male Factor Infertility and the Rural-Urban Continuum.

Devon M Langston1, Kiarad Fendereski2, Joshua Halpern3

  • 1Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT.

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Summary

Men in rural areas face greater challenges with infertility, experiencing lower success rates and longer times to achieve pregnancy compared to those in metropolitan regions. This highlights disparities in fertility care across the rural-urban divide.

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Area of Science:

  • Reproductive Medicine
  • Environmental Health
  • Demography

Background:

  • Male factor infertility is a significant concern impacting reproductive health.
  • Geographic location, specifically the rural-urban continuum, may influence infertility diagnosis and outcomes.
  • Understanding these disparities is crucial for equitable healthcare delivery.

Purpose of the Study:

  • To investigate the association between male factor infertility and geographic location along the rural-urban continuum.
  • To determine if residence in metropolitan versus non-metropolitan areas impacts fertility outcomes.
  • To identify potential disparities in fertility treatment utilization and success rates based on location.

Main Methods:

  • A retrospective cohort study utilized the Utah Population Database, linking demographic, medical, and residential data.
  • Fertility data from 1998 to 2017 were analyzed.
  • Participants were categorized based on United States Department of Agriculture rural-urban continuum codes into metropolitan and non-metropolitan classifications.

Main Results:

  • Males in non-metropolitan urban/rural areas were less likely to be racial/ethnic minorities and less likely to use assisted reproductive technology.
  • Complete rurality was significantly associated with a decreased likelihood of successful fertility outcomes (HR 0.60).
  • Complete rurality was also linked to a longer time to achieve a successful fertility outcome (over 60 months vs. ~34 months in metro areas).

Conclusions:

  • Metropolitan residence is associated with higher rates of racial/ethnic diversity, fertility treatment utilization, and successful fertility outcomes.
  • Significant disparities in fertility care and outcomes exist across the rural-urban continuum.
  • These findings underscore the need for tailored infertility care strategies for rural populations.