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Abstract：
The EAU guidelines on male sexual and reproductive health state that both partners of the infertile couple should undergo simultaneous investigation.
To assess the prevalence and the characteristics of infertile men who were referred for an andrological evaluation after failed attempts of Assisted Reproductive Technology (ART) with those who were evaluated at the beginning of their infertility pathway at a single academic centre over a 17-year period.
Data of 3213 primary infertile couples assessed between 2003 and 2020 were analysed. Descriptive statistics compared the overall characteristics of male partners of couples with (+ART) or without (-ART) previous ART prior to andrological consultation. Logistic regression models analysed variables associated with +ART. Local polynomial regression models explored the probability of +ART over the analysed time frame.
Of all, 493 (15.3%) participants were +ART. Patients and female partners\' age was higher in +ART couples (all p ≤ 0.04). Sperm concentration, progressive sperm motility and normal sperm morphology were lower in +ART than in -ART patients (all p < 0.001), along with a greater percentage of non-obstructive azoospermia in +ART compared to -ART men (p < 0.0001). At univariable analysis, patient age and partner age >35 years and a less recent assessment were associated with +ART status (all p ≤ 0.04). Male age and less recent years of assessment were also independent predictors of +ART, after accounting for partner\'s age >35 years (all p < 0.01). A not significant decrease of this pattern was observed throughout the last 7 years at local polynomial regression models.
Overall awareness towards the importance of a comprehensive evaluation for the male partner of every infertile couple should therefore be further strengthened.
Approximately 15% of couples still undergo ART without any initial andrological evaluation in the real-life setting. A not significant decrease in this trend was observed over most recent years.
To assess the prevalence and the characteristics of infertile men who were referred for an andrological evaluation after failed attempts of Assisted Reproductive Technology (ART) with those who were evaluated at the beginning of their infertility pathway at a single academic centre over a 17-year period.
Data of 3213 primary infertile couples assessed between 2003 and 2020 were analysed. Descriptive statistics compared the overall characteristics of male partners of couples with (+ART) or without (-ART) previous ART prior to andrological consultation. Logistic regression models analysed variables associated with +ART. Local polynomial regression models explored the probability of +ART over the analysed time frame.
Of all, 493 (15.3%) participants were +ART. Patients and female partners\' age was higher in +ART couples (all p ≤ 0.04). Sperm concentration, progressive sperm motility and normal sperm morphology were lower in +ART than in -ART patients (all p < 0.001), along with a greater percentage of non-obstructive azoospermia in +ART compared to -ART men (p < 0.0001). At univariable analysis, patient age and partner age >35 years and a less recent assessment were associated with +ART status (all p ≤ 0.04). Male age and less recent years of assessment were also independent predictors of +ART, after accounting for partner\'s age >35 years (all p < 0.01). A not significant decrease of this pattern was observed throughout the last 7 years at local polynomial regression models.
Overall awareness towards the importance of a comprehensive evaluation for the male partner of every infertile couple should therefore be further strengthened.
Approximately 15% of couples still undergo ART without any initial andrological evaluation in the real-life setting. A not significant decrease in this trend was observed over most recent years.
摘要：
EAU关于男性性健康和生殖健康的指南指出，不育夫妇的两个伴侣都应同时进行调查。
评估不孕男性的患病率和特征，这些男性在辅助生殖技术（ART）尝试失败后被转介进行男性评估，这些男性在17年的时间内在一个学术中心进行不孕途径开始时进行评估。
分析了2003年至2020年间评估的3213对原发性不育夫妇的数据。描述性统计比较了在进行男科咨询之前有（ART）或没有（-ART）先前ART的夫妇的男性伴侣的总体特征。Logistic回归模型分析了与+ART相关的变量。局部多项式回归模型探索了在分析的时间范围内+ART的概率。
其中,493名（15.3%）参与者为+ART。+ART夫妇的患者和女性伴侣年龄较高（所有p≤0.04）。精子浓度,+ART患者的进行性精子活力和正常精子形态低于-ART患者(均p<0.001)，与-ART男性相比，+ART男性非梗阻性无精子症的比例更高(p<0.0001)。在单变量分析中，患者年龄和伴侣年龄>35岁以及最近的评估与+ART状态相关(均p≤0.04).男性年龄和最近几年的评估也是+ART的独立预测因素，考虑到伴侣的年龄>35岁（所有p<0.01）。在过去的7年中，在局部多项式回归模型中观察到这种模式没有显着下降。
因此，应进一步加强对每对不育夫妇的男性伴侣进行综合评估的重要性的总体认识。
在现实生活中，大约15%的夫妇仍在接受ART，没有任何初步的男性评估。在最近几年中，这一趋势没有显着下降。
评估不孕男性的患病率和特征，这些男性在辅助生殖技术（ART）尝试失败后被转介进行男性评估，这些男性在17年的时间内在一个学术中心进行不孕途径开始时进行评估。
分析了2003年至2020年间评估的3213对原发性不育夫妇的数据。描述性统计比较了在进行男科咨询之前有（ART）或没有（-ART）先前ART的夫妇的男性伴侣的总体特征。Logistic回归模型分析了与+ART相关的变量。局部多项式回归模型探索了在分析的时间范围内+ART的概率。
其中,493名（15.3%）参与者为+ART。+ART夫妇的患者和女性伴侣年龄较高（所有p≤0.04）。精子浓度,+ART患者的进行性精子活力和正常精子形态低于-ART患者(均p<0.001)，与-ART男性相比，+ART男性非梗阻性无精子症的比例更高(p<0.0001)。在单变量分析中，患者年龄和伴侣年龄>35岁以及最近的评估与+ART状态相关(均p≤0.04).男性年龄和最近几年的评估也是+ART的独立预测因素，考虑到伴侣的年龄>35岁（所有p<0.01）。在过去的7年中，在局部多项式回归模型中观察到这种模式没有显着下降。
因此，应进一步加强对每对不育夫妇的男性伴侣进行综合评估的重要性的总体认识。
在现实生活中，大约15%的夫妇仍在接受ART，没有任何初步的男性评估。在最近几年中，这一趋势没有显着下降。
