Infertile couples still undergo assisted reproductive treatments without initial andrological evaluation in the real-life setting: A failure to adhere to guidelines?

BACKGROUND: The EAU guidelines on male sexual and reproductive health state that both partners of the infertile couple should undergo simultaneous investigation. OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: 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. DISCUSSION: Overall awareness towards the importance of a comprehensive evaluation for the male partner of every infertile couple should therefore be further strengthened. CONCLUSIONS: 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.

Italian experiences in the management of andrological patients at the time of Coronavirus pandemic.

The SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) was first reported in December 2019, then its rapid spread around the world caused a global pandemic in March 2020 recording a high death rate. The epicenter of the victims moved from Asia to Europe and then to the United States. In this Pandemic, the different governance mechanisms adopted by local health regional authorities made the difference in terms of contagiousness and mortality together with a community strong solidarity. This document analyzes the andrological urgencies management in public hospitals and in private practice observed in Italy and in particular in the most affected Italian Regions: Emilia-Romagna and Marche.

Is there plagiarism in the most influential publications in the field of andrology?

Plagiarism is a common form of academic misconduct that extensively jeopardises the quality of scientific publication. The purpose of this study is to determine the extent of plagiarism in the most influential andrology articles. A total of 77 highly cited andrology articles were analysed for their similarity index using iThenticate and Turnitin. The articles were categorised based on the year (before and on/after 2000) and type of publication (review and research articles), and the similarity indices were compared. Furthermore, the analysed articles were categorised based on the level of similarity using an arbitrary similarity index range (low: ≤10, moderate: 11-20, high: 21-50 and very high: >50) and average incidence rate (%) was determined. Our analysis revealed a higher percentage of the similarity indices for reviews than research articles. We noticed a higher similarity index for articles published on/after 2000 than those published before. The majority of the influential articles in the field of andrology showed a low similarity index, while some articles exhibited moderate to high levels of similarity. These findings support the need for the development of similarity index guidelines as a major pre-requisite for establishing a more transparent and efficient system to address plagiarism in scientific publications.

[Andrology - Whom and how are patients being referred?] / A referenciação para a consulta de andrologia ­ Quem e como são referenciados?

INTRODUCTION: Andrology focuses in male sexual and fertility diseases. Its referral should be thoughtful and tailored in order to select the correct cases. OBJECTIVES: The aim of this work was to evaluate the referral to our department and improvement points. MATERIAL AND METHODS: A retrospective analysis was performed of the Andrology consults between January 2014 and December 2015. RESULTS: We evaluated 96 of the 102 consults performed. About 60% of patients were referred with erectile dysfunction complaints, 15% with penile curvature and 8% with ejaculatory dysfunction. About 27% had previously tried phosphodiesterase 5 inhibitor, and 40% lacked recent metabolic workup. DISCUSSION: The high prevalence of sexual complaints coupled with a high number of naïve patients could be due to difficulties by the referral doctors when analyzing and characterizing male sexual dysfunction according to the current sexual response cycle model. The lack of patient categorization accordingly to Princeton criteria (III) shows the difficulties found when selecting patients to start the first line of treatment for erectile dysfunction. CONCLUSION: Sexual dysfunction are highly prevalent in the general population. Healthcare providers should improve diagnostic and treatment skills in this field of Urology.

Adolescence and andrologist: An imperfect couple.

OBJECTIVE: The aims of this research were to study: a) the prevalence of male adolescents, aged between 10 and 19 years of age, referred to our Unit for an andrological assessment; b) the reasons (stated and subsequently modified) for referral; c) the prevalence of clinically diagnosed diseases. MATERIALS AND METHODS: A total of 2.855 subjects, referred to the Andrology Unit for a first examination, were retrospectively studied. For each adolescent, a medical history was taken and an andrological physical examination was carried out. RESULTS: Prevalence was found to be 6.9% (197/2855). Subjects were divided into two groups according to age (A: ≤ 14 and B: ≥ 15 years). The original reason stated for their consultation was corrected by 11.7% of the subjects (23/197); this correction concerned almost all the Group B subjects (21/23 (91.3%) vs 2/23 (8.7%) of Group A; p < 0.01). Regarding sexual dysfunctions, a simple explanation of certain conditions reassured the subject in about 15% of the cases. Furthermore, the physical examination proved extremely useful, revealing clinical alterations in more than 60% of subjects. CONCLUSIONS: In conclusion, to date in Italy, the prevalence of adolescents among males referred to an Andrology Unit for assessment is very low. It is important to encourage adolescents to undergo andrological examination to enable identification of reproductive function and psycho-sexual disorders.

[Mental health of prostatitis patients in China: A statistical analysis of literature].

OBJECTIVE: To know the basic status of researches on the mental health of prostatitis patients in China by statistical analysis of the literature published in the past two decades and provide some reference for such studies. METHODS: Using the bibliometrics method, we performed statistical analyses on the publication years, journals, and authors of the articles published in the core journals concerning the mental health of prostatitis patients in China as well as on the topics of the identified studies using their titles, key words and abstracts. RESULTS: Totally, 226 related studies were identified, of which 31 (by 29 authors) were published in the Chinese core journals. As for the topics of the included studies, 102 (45.13%) focused on the role and significance of psychotherapy in the treatment of prostatitis, 52 (23.01%) on the correlation of psychological factors with prostatitis, and 23 (10.18%) on the correlation of psychopathic factors with prostatitis complicated by sexual dysfunction. Most of the articles on the mental health of prostatitis patients were published in National Journal of Andrology. CONCLUSIONS: Studies on the mental health of prostatitis patients in China are carried out in varied institutions and different directions but, however, need to be furthered and deepened. For this condition, a comprehensive therapeutic mode of "prevention-communication-treatment" is coming into being, and the methodology for related researches is gradually turning from linear to stereoscopic.

[Sexual medicine in daily practice : Germany-wide questionnaire of urologists]. / Sexualmedizin im ärztlichen Alltag : Bundesweite Umfrage unter Ärzten in der Urologie.

BACKGROUND: Sexual-related problems are very prevalent. Physicians of different disciplines are frequently contacted by men with those problems. OBJECTIVES: The aim of this study was to investigate the situation of sexual medicine in daily practice and to evaluate German urologists' need for further training in this field with a focus on gender-specific differences. MATERIALS AND METHODS: A five-page questionnaire included questions about sexual medicine in daily practice. A focus was set on physicians dealing with sexual medicine in daily practice and their need for further training in this field. In April/Mai 2015, questionnaires were sent per mail to 5955 urologists, urology residents and andrologists throughout Germany. The questionnaire was developed based on previously published studies and a pretest was performed to evaluate comprehensibility. A χ2 test was performed to determine significant gender-specific differences; for this propose response options were dichotomised. P values ≤0.05 were considered significant. RESULTS: The response rate was 16.0%, representing 955 questionnaires. A total of 50 questionnaires from non-urologists were excluded, so 905 questionnaires were analysed. The mean age was 47.7 ± 10.4 years, 78.9% were male, 97.0% had studied in Germany, 86.7% were specialists and 37.7% had further qualification in andrology. CONCLUSION: Our results emphasize the need for further training in sexual medicine, especially for female physicians. This study underlines the demand for advanced qualification in sexual medicine.

The sexual double standard in a masculine way: Portuguese transgenerational perspective

IntroductionThe relationship between both genders has conditioned different ways concerning the expression of sexuality.ObjectiveThis investigation analysed the evolution of the sexual double standard and its relations with sexual satisfaction, concerning the Portuguese context.Material and methodsTo do so, 2 different male samples were compared: one aged from 20-30 years and the other aged from 40-50 years, considering the possibility of a certain “transgenerational effect” in transmitting sexual standards.ResultsThe results show that sexual satisfaction is not correlated with personal acceptance of the sexual double standard, and that we are not abandoning the sexual double standard in order to establish a more egalitarian one.DiscussionAlthough both groups recognise the social pervasiveness of the sexual double standard, younger men are more attached to the sexual double standard when compared to older ones.ConclusionsSuch results can be seen in a way of a certain “masculine fear” about women's emancipation, and the need for a social adequateness. At the end, some suggestions are made considering the results (AU)

Introdução. A relação entre géneros tem condicionado a expressão da sexualidade ao longo das diversas épocas históricas. Objetivo. A presente investigação visa analisar a evolução do fenómeno de duplo padrão sexual e relacioná-lo com o conceito de satisfação sexual, no que concerne ao caso português. Material e métodos. Foram comparados 2 grupos do sexo masculino, com homens dos 20-30 anos e dos 40-50 anos, avaliando-se a possibilidade de um «efeito de geração» na transmissão de padrões sexuais. Resultados. Contrariamente ao esperado, a satisfação sexual não estava relacionada com a defesa pessoal do duplo padrão sexual nem houve abandono do duplo padrão sexual em favor de um padrão mais igualitário. Discussão. Embora ambos os grupos etários reconheçam a existência social do duplo padrão sexual, os homens mais jovens revelam estar mais apegados ao duplo padrão sexual relativamente aos homens mais velhos. Conclusões. Tais resultados podem ser vistos à luz dum certo receio masculino acerca da emancipação da mulher e também de uma certa necessidade de normatividade social. Por fim, são apontadas algumas sugestões para a intervenção clínica, considerando os resultados obtidos (AU)

Concentración espermática ¿necesitamos un nuevo valor de referencia? / Sperm count Do we need a new reference value?

OBJETIVOS: Evaluar las concentraciones espermáticas de individuos fértiles, población general e individuos infértiles en diferentes regiones del mundo.MÉTODOS: Las concentraciones espermáticas de diferentes estudios según el estado fértil de cada individuo fue evaluada: individuos con fertilidad comprobada, individuos que consultan a una clínica de andrología o centro de infertilidad y población general.RESULTADO: El promedio de la concentración espermática observada en los estudios para cada grupo fue diferente, siendo menos en los hombres infértiles comparado con los hombres fértiles (p>0.001) y la población general (p>0.001).CONCLUSIONES: Basado en este análisis, la concentración normal estaría alrededor de 65 millones por mL. Usando valor de referencia, solo el 25% de los estudios con hombres infértiles estaría por encima del rango, y el 75% de los estudios con hombres fértiles estarían en este grupo (>65 x 106 espermatozoides/mL)(AU)

OBJECTIVES:To evaluate the sperm count in fertile men, general population, and infertile men in different regions of the world.METHODS: Sperm counts were recorded according to their fertility status, proven fertility, men recruited from an andrology/infertility clinic, or healthy menRESULTS: The average of sperm count in the different studies is lower in infertile men that in fertile men (p>0.001) and in the general population (p>0.001).CONCLUSION: Based on this analysis the normal sperm count is about 65 million per mL. Using these reference value, only the 25% of the studies in infertile men are above this value, and the 75% studies with fertile men (>65 x 106 sperm/mL)(AU)

[Citation analysis of National Journal of Andrology and Asian Journal of Andrology].

OBJECTIVE: To analyze the distribution pattern of the references in National Journal of Andrology (NJA) and Asian Journal of Andrology (AJA), and evaluate the ability of information collection and the characteristics of literatures requested by scientists of andrology. METHODS: The citation analysis was used to analyze the references cited by articles published on the two journals, including the number, type and publication year of references, and Price Index, self-citing rate of the two journals and top cited journals were analyzed individually. RESULTS: The average numbers of references per article in AJA and NJA were 20.43 and 10.18 respectively, and the percentages of journals cited by the two journals were 95.84% and 93%. The Price indices were 38.50% and 55.01%, and self-citing rates were 6.20% and 5.82% for the two journals respectively. There were 358 and 725 journals cited by AJA and NJA, the top 12 of which provided 42.47% and 37.41% of all references respectively. CONCLUSION: The main reference type was journal. NJA cited more disciplines than AJA did, and it cited more current publications. The result shows authors in NJA can use latest articles and keep abreast of progress in andrology. AJA had more references and relatively concentrated cited journal categories, and citing half-life of AJA was longer than that of NJA.

[Statistical analysis of fund sponsored articles in National Journal of Andrology].

OBJECTIVE: To evaluate the academic level and influence of National Journal of Andrology through statistical analysis for the fund sponsored articles. METHODS: Utilizing the information from China Hospital Knowledge Database (CHKD), and adopting bibliometrics methods, we carried on statistical analysis for the fund sponsored articles published on National Journal of Andrology dated from Mar. 2000 to Jun. 2005. RESULTS: Nine hundred and fourty-two articles were screened, of which 204 (21.7%) were fund sponsored, and the proportion of the articles supported by various funds, including the funds from national key projects, presented an increasing tendency every year. The authors were distributed among 30 provinces and 6 oversea countries with an average age 37.4 years old, of whom 37.7% got doctor's degree and 38.7% masters degree. The articles involved clinical research were at 28.9%, and basic study and applied study were at 71.1%, respectively. CONCLUSION: The articles supported by various funds in National Journal of Andrology have taken a high percentage, so the journal achieves a fine academic level and social influence.

Does the potential for selection bias in semen quality studies depend on study design? Experience from a study conducted within an infertility clinic.

BACKGROUND: The low participation rates in human semen quality studies raises concern for the potential of differential participation based on semen quality (or a surrogate). To explore the potential for differential participation, we compared semen analysis results from study subjects with those of non-study subjects. METHODS: We obtained semen analysis results from 235 study subjects and retrospectively obtained results from a subset of 235 infertility clinic patients that were not study subjects but met the same eligibility criteria. The study was conducted at the Massachusetts General Hospital Infertility Clinic. All semen samples (study subjects and non-study subjects) were analysed for sperm concentration and motility by computer-aided semen analysis (CASA), and morphology was assessed using strict criteria. Semen analysis parameters for the non-study subjects were compared with the semen analysis results from study subjects. RESULTS: For all semen characteristics (sperm concentration, total sperm count, sperm motility and morphology), there were only marginal (non-significant) differences between study subjects and non-study subjects. CONCLUSIONS: Among men from an infertility clinic, we found no strong evidence of differential participation based on semen quality. This is reassuring since the potential for selection bias is of concern in semen quality studies. However, the potential for selection bias in other study designs remains unclear.

[A citation analysis of National Journal of Andrology].

OBJECTIVE: To evaluate the academic level and the popularity of National Journal of Andrology. METHODS: According to the information of Chinese Medical Citation Index (CMCI), a statistical analysis was made of the amount and distribution of the originals published in National Journal of Andrology and cited by the journals included by CMCI. RESULTS: The originals published in National Journal of Andrology were highly qualified and influential, with their authors widely distributed all over China and even in some parts of the world. CONCLUSION: With its unique academic style and character, National Journal of Andrology is a main core periodical of medicine, as well as one of the most important information resources in the field of andrology in China.

[Analysis of articles and citations in National Journal of Andrology (2000-2002)].

OBJECTIVES: To evaluate the academic status and influence of the National Journal of Andrology (NJA). METHODS: The data of articles and citations in 16 issues of NJA (2000-2002) were collected, then the quality of this journal was evaluated in terms of bibliometric parameters. RESULTS: Except for reviews and translations, the sums of original papers accounted for 183 (53.5%), the articles with citation in 16 issues were 333 (97.08%), and funded project papers accounted for 62 (18.08%). The number of the articles and funded project papers increased every year; the average publishing cycle of the articles was 8.7 months; the average number of authors was 3.7 per article; the average age of the first author was 36.3 years old; the authors distributed in 30 provinces, 43.37% of the authors had senior professional title and 40.80% of the authors had master's or doctor's degrees, the journal had a high rate of self-citation (6.30%). CONCLUSIONS: National Journal of Andrology is a high quality journal, with excellent authors, strong influence and bright future.

Understanding the epidemiology of fertility treatments.

The science of statistics forms the basis of much of what urologists do and why. Understanding basic statistics is crucial to the appropriate interpretation of urologic studies. As valid as they are, the statistics taught in medical school represent only a small part of what computation can do for the urologist. Contemporary tools such as neural computation coupled with electronic technology that provides increasingly greater computational power in smaller space hold promise to integrate into the field of clinical urology as seamlessly as a ballpoint pen or cystoscope.