Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility?
Purpose: Overall, male factor infertility (MFI) accounts for up to 50% of etiologies of couple’s infertility, with almost 30% of MFI cases being idiopathic in nature. Idiopathic MFI does not support a tailored treatment work-up in clinical practice. To investigate rates of and characteristics of m...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2023-04-01
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| Series: | The World Journal of Men's Health |
| Subjects: |
| _version_ | 1827987705860980736 |
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| author | Christian Corsini Luca Boeri Luigi Candela Edoardo Pozzi Federico Belladelli Paolo Capogrosso Giuseppe Fallara Nicolò Schifano Daniele Cignoli Eugenio Ventimiglia Alessia D’Arma Massimo Alfano Francesco Montorsi Andrea Salonia |
| author_facet | Christian Corsini Luca Boeri Luigi Candela Edoardo Pozzi Federico Belladelli Paolo Capogrosso Giuseppe Fallara Nicolò Schifano Daniele Cignoli Eugenio Ventimiglia Alessia D’Arma Massimo Alfano Francesco Montorsi Andrea Salonia |
| author_sort | Christian Corsini |
| collection | DOAJ |
| description | Purpose: Overall, male factor infertility (MFI) accounts for up to 50% of etiologies of couple’s infertility, with almost 30% of
MFI cases being idiopathic in nature. Idiopathic MFI does not support a tailored treatment work-up in clinical practice. To investigate
rates of and characteristics of men presenting for idiopathic versus unexplained primary infertility as compared with
same-ethnicity, age-comparable fertile men.
Materials and Methods: Demographic, clinical and laboratory data from 3,098 primary infertile men consecutively evaluated
were analyzed and compared with those of 103 fertile controls. Idiopathic male infertility (IMI) was defined for abnormality
at semen analysis with no previous history of diseases affecting fertility and normal findings on physical examination and genetic
and laboratory testing. Unexplained male infertility (UMI) was defined as infertility of unknown origin with completely
normal findings at semen analysis. Descriptive statistics and logistic regression models tested the association between clinical
variables and idiopathic infertility status.
Results: Overall, 570 (18.5%) and 154 (5.0%) patients depicted criteria suggestive for either IMI or UMI, respectively. Groups
were similar in terms of age, BMI, CCI, recreational habits, hormonal milieu, and sperm DNA fragmentation indexes. Conversely,
testicular volume was lower in IMI (p<0.001). Vitamin D3 levels were lower in IMI vs. UMI vs. fertile controls (p=0.01).
At multivariable logistic regression analysis only vitamin D3 deficiency (OR, 9.67; p=0.03) was associated with IMI. Characteristics
suggestive for IMI versus UMI were observed in almost 20% and 5% of men, respectively. Overall, clinical differences
between groups were slightly significant and certainly not supportive of a tailored management work-up.
Conclusions: Current findings further support the urgent need of a more detailed and comprehensive assessment of infertile
men to better tailoring their management work-up in the everyday clinical setting. |
| first_indexed | 2024-04-09T23:52:16Z |
| format | Article |
| id | doaj.art-3bf15914447d47d69c9bc48c49e4be2f |
| institution | Directory Open Access Journal |
| issn | 2287-4208 2287-4690 |
| language | English |
| last_indexed | 2024-04-09T23:52:16Z |
| publishDate | 2023-04-01 |
| publisher | Korean Society for Sexual Medicine and Andrology |
| record_format | Article |
| series | The World Journal of Men's Health |
| spelling | doaj.art-3bf15914447d47d69c9bc48c49e4be2f2023-03-17T06:10:23ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902023-04-0141235436210.5534/wjmh.220069Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility?Christian Corsini0https://orcid.org/0000-0001-9603-1589Luca Boeri1https://orcid.org/0000-0003-0040-784XLuigi Candela2https://orcid.org/0000-0002-0593-8802Edoardo Pozzi3https://orcid.org/0000-0002-0228-7039Federico Belladelli4https://orcid.org/0000-0002-2165-659XPaolo Capogrosso5https://orcid.org/0000-0003-2347-9504Giuseppe Fallara6https://orcid.org/0000-0001-7872-2650Nicolò Schifano7https://orcid.org/0000-0003-4828-4316Daniele Cignoli8https://orcid.org/0000-0001-7873-7318Eugenio Ventimiglia9https://orcid.org/0000-0003-3654-1629Alessia D’Arma10https://orcid.org/0000-0002-4855-4577Massimo Alfano11https://orcid.org/0000-0002-6904-9158Francesco Montorsi12https://orcid.org/0000-0002-7267-4181Andrea Salonia13https://orcid.org/0000-0002-0595-7165Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDepartment of Urology, Foundation IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, University of MilanDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDepartment of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, ItalyDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaeleDivision of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San RaffaelePurpose: Overall, male factor infertility (MFI) accounts for up to 50% of etiologies of couple’s infertility, with almost 30% of MFI cases being idiopathic in nature. Idiopathic MFI does not support a tailored treatment work-up in clinical practice. To investigate rates of and characteristics of men presenting for idiopathic versus unexplained primary infertility as compared with same-ethnicity, age-comparable fertile men. Materials and Methods: Demographic, clinical and laboratory data from 3,098 primary infertile men consecutively evaluated were analyzed and compared with those of 103 fertile controls. Idiopathic male infertility (IMI) was defined for abnormality at semen analysis with no previous history of diseases affecting fertility and normal findings on physical examination and genetic and laboratory testing. Unexplained male infertility (UMI) was defined as infertility of unknown origin with completely normal findings at semen analysis. Descriptive statistics and logistic regression models tested the association between clinical variables and idiopathic infertility status. Results: Overall, 570 (18.5%) and 154 (5.0%) patients depicted criteria suggestive for either IMI or UMI, respectively. Groups were similar in terms of age, BMI, CCI, recreational habits, hormonal milieu, and sperm DNA fragmentation indexes. Conversely, testicular volume was lower in IMI (p<0.001). Vitamin D3 levels were lower in IMI vs. UMI vs. fertile controls (p=0.01). At multivariable logistic regression analysis only vitamin D3 deficiency (OR, 9.67; p=0.03) was associated with IMI. Characteristics suggestive for IMI versus UMI were observed in almost 20% and 5% of men, respectively. Overall, clinical differences between groups were slightly significant and certainly not supportive of a tailored management work-up. Conclusions: Current findings further support the urgent need of a more detailed and comprehensive assessment of infertile men to better tailoring their management work-up in the everyday clinical setting.andrologyinfertilityinfertility etiologytestis abnormalitiesvitamin d |
| spellingShingle | Christian Corsini Luca Boeri Luigi Candela Edoardo Pozzi Federico Belladelli Paolo Capogrosso Giuseppe Fallara Nicolò Schifano Daniele Cignoli Eugenio Ventimiglia Alessia D’Arma Massimo Alfano Francesco Montorsi Andrea Salonia Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility? The World Journal of Men's Health andrology infertility infertility etiology testis abnormalities vitamin d |
| title | Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility? |
| title_full | Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility? |
| title_fullStr | Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility? |
| title_full_unstemmed | Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility? |
| title_short | Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility? |
| title_sort | is there a relevant clinical impact in differentiating idiopathic versus unexplained male infertility |
| topic | andrology infertility infertility etiology testis abnormalities vitamin d |
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