Understanding general public and healthcare provider knowledge gaps in male factor infertility

While ongoing research continues to identify new causes for decreased sperm counts and idiopathic infertility, little objective data are known regarding public knowledge and perception of male infertility. In this study, we aim to better characterize male infertility knowledge across educational status, personal experience with infertility, socioeconomic characteristics, and income level.

Participants were asked to identify, among other factors, out-of-pocket treatment cost, insurance coverage, and potential risk factors for infertility. Then, a scoring system was developed to objectively quantify overall understanding of male infertility and named Knowledge of Male Fertility (KM-Fert). Results were compared by socioeconomic status and education level, with a sub-analysis of healthcare professionals (HCPs).

A total of 242 respondents completed the survey. Only 67.4% of respondents (n=163) identified testosterone therapy as a risk factor for male infertility, while other commonly understood risk factors (e.g., smoking or obesity) were correctly identified by a large majority. Median KM-Fert score of reproductive urology subspecialists was a perfect score of 10. This was significantly higher than other respondents {10 [interquartile range (IQR): 9.25, 10] vs. 7 (IQR: 5, 8), P<0.001}. Education level influenced KM-Fert score (P<0.001). Post-hoc analysis demonstrated a significantly higher median score for medical school graduates versus all other education levels except for nurse practitioner or physician assistant graduates (P=0.28).

The general population has variable knowledge surrounding male fertility, and there is an opportunity for non-urology providers to improve their knowledge, screening, and referrals for reproductive-aged males. Reproductive urologists may be the ideal group to educate fellow HCPs.