A unique view on male infertility around the globe

Ashok Agarwal, Aditi Mulgund, Alaa Hamada, Michelle Renee Chyatte, Ashok Agarwal, Aditi Mulgund, Alaa Hamada, Michelle Renee Chyatte

Abstract

Background: Infertility affects an estimated 15% of couples globally, amounting to 48.5 million couples. Males are found to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall. However, this number does not accurately represent all regions of the world. Indeed, on a global level, there is a lack of accurate statistics on rates of male infertility. Our report examines major regions of the world and reports rates of male infertility based on data on female infertility.

Methods: Our search consisted of systematic reviews, meta-analyses, and population-based studies by searching the terms "epidemiology, male infertility, and prevalence." We identified 16 articles for detailed study. We typically used the assumption that 50% of all cases of infertility are due to female factors alone, 20-30% are due to male factors alone, and the remaining 20-30% are due to a combination of male and female factors. Therefore, in regions of the world where male factor or rates of male infertility were not reported, we used this assumption to calculate general rates of male factor infertility.

Results: Our calculated data showed that the distribution of infertility due to male factor ranged from 20% to 70% and that the percentage of infertile men ranged from 2·5% to 12%. Infertility rates were highest in Africa and Central/Eastern Europe. Additionally, according to a variety of sources, rates of male infertility in North America, Australia, and Central and Eastern Europe varied from 4 5-6%, 9%, and 8-12%, respectively.

Conclusion: This study demonstrates a novel and unique way to calculate the distribution of male infertility around the world. According to our results, at least 30 million men worldwide are infertile with the highest rates in Africa and Eastern Europe. Results indicate further research is needed regarding etiology and treatment, reduce stigma & cultural barriers, and establish a more precise calculation.

Figures

Figure 1
Figure 1
Flow chart demonstrating methodology. This figure is a representation of our methods, including number of articles found and filtered, and inclusion and exclusion criteria for the final article selection.
Figure 2
Figure 2
World map containing percentages of infertility cases per region that are due to male factor. This figure demonstrates rates of infertility cases in each region studied (North America, Latin America, Africa, Europe, Central/Eastern Europe, Middle East, Asia, and Oceania) due to male factor involvement.

References

    1. Sharlip ID, Jarow JP, Belker AM, Lipshultz LI, Sigman M, Thomas AJ, et al. Best practice policies for male infertility. Fertil Steril. 2002;77:873–82. doi: 10.1016/S0015-0282(02)03105-9.
    1. Matetakufa SN. Infertility: Our Own Gift. New Internationalist. 1998. Accessed 17 December 2014.
    1. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med. 2012;9:e1001356. doi: 10.1371/journal.pmed.1001356.
    1. Martinez G, Daniels K, Chandra A. Fertility of men and women aged 15-44 years in the United States: National Survey of Family Growth, 2006-2010. Natl Health Stat Report. 2012;51:1–28.
    1. Winters BR, Walsh TJ. The Epidemiology of Male Infertility. Urol Clin North Am. 2014;41:195–204. doi: 10.1016/j.ucl.2013.08.006.
    1. Bablok L, Dziadecki W, Szymusik I, Wolczynski S, Kurzawa R, Pawelczyk L, et al. Patterns of infertility in Poland - multicenter study. Neuro Endocrinol Lett. 2011;32:799–804.
    1. Inhorn MC, Buss KA. Ethnography, epidemiology and infertility in Egypt. Soc Sci Med. 1994;39:671–86. doi: 10.1016/0277-9536(94)90023-X.
    1. Aflatoonian A, Seyedhassani SM, Tabibnejad N. The epidemiological and etiological aspects of infertility in Yazd province of Iran. Iran J Reprod Med. 2009;7:117–22.
    1. Elussein EA, Magid YM, Omer MM, Adam I. Clinical patterns and major causes of infertility among Sudanese couples. Trop Doct. 2008;38:243–4. doi: 10.1258/td.2007.070125.
    1. Collins HP, Kalisch D. The health of Australia’s males. Health. Canberra: Australian Institute of Health and Welfare; 2011.
    1. Jungwirth A, Giwercman A, Tournaye H, Diemer T, Kopa Z, Dohle G, et al. European association of urology guidelines on male infertility: the 2012 update. Eur Urol. 2012;62:324–32. doi: 10.1016/j.eururo.2012.04.048.
    1. Olsen J, Kuppers-Chinnow M, Spinelli A. Seeking medical help for subfecundity: a study based upon surveys in five European countries. Fertil Steril. 1996;66:95–100.
    1. Thonneau P, Marchand S, Tallec A, Ferial ML, Ducot B, Lansac J, et al. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989) Hum Reprod. 1991;6:811–6.
    1. Sanocka D, Kurpisz M. Infertility in Poland–present status, reasons and prognosis as a reflection of Central and Eastern Europe problems with reproduction. Med Sci Monit. 2003;9:SR16–20.
    1. McLachlan RI, de Kretser DM. Male infertility: the case for continued research. Med J Aust. 2001;174:116–7.
    1. Rutstein SO, Shah IH. Infecundity, infertility, and childlessness in developing countries. DHS Comparative Reports No. 9. Geneva: World Health Organization; 2004.
    1. Cates W, Farley TM, Rowe PJ. Worldwide patterns of infertility: is Africa different? The Lancet. 1985;326:596–8. doi: 10.1016/S0140-6736(85)90594-X.
    1. Sembuya R. Mother or nothing: the agony of infertility. Bull World Health Organ. 2010;88:881–2. doi: 10.2471/BLT.10.011210.
    1. Ikechebelu J, Adinma J, Orie E, Ikegwuonu S. High prevalence of male infertility in southeastern Nigeria. J Obstetrics Gynecology. 2003;23:657–9. doi: 10.1080/01443610310001604475.
    1. Araoye MO. Epidemiology of infertility: social problems of the infertile couples. West Afr J Med. 2004;22:190–6.
    1. Inhorn MC. Middle Eastern masculinities in the age of new reproductive technologies: male infertility and stigma in Egypt and Lebanon. Med Anthropol Q. 2004;18:162–82. doi: 10.1525/maq.2004.18.2.162.
    1. Lunenfeld B, Van Steirteghem A, on behalf of all participants Infertility in the third millennium: implications for the individual, family and society: Condensed Meeting Report from the Bertarelli Foundation's Second Global Conference. Hum Reprod Update. 2004;10:317–26. doi: 10.1093/humupd/dmh028.
    1. Collet M, Reniers J, Frost E, Gass R, Yvert F, Leclerc A, et al. Infertility in Central Africa: infection is the cause. Int J Gynaecol Obstet. 1988;26:423–8. doi: 10.1016/0020-7292(88)90340-2.
    1. Cooper TG, Noonan E, Eckardstein S, Auger J, Baker HWG, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16:231–45. doi: 10.1093/humupd/dmp048.
    1. Esteves SC, Zini A, Aziz N, Alvarez JG, Sabanegh ES, Agarwal A. Critical Appraisal of World Health Organization's New Reference Values for Human Semen Characteristics and Effect on Diagnosis and Treatment of Subfertile Men. Urology. 2012;79:16–22. doi: 10.1016/j.urology.2011.08.003.
    1. Wilcox AJ. Fertility and pregnancy: an epidemiologic perspective. 1. New York: Oxford University Press; 2010.
    1. Philippov OS, Radionchenko AA, Bolotova VP, Voronovskaya NI, Potemkina TV. Estimation of the prevalence and causes of infertility in western Siberia. Bull World Health Organ. 1998;76(2):183.
    1. Bayasgalan G, Naranbat D, Tsedmaa B, Tsogmaa B, Sukhee D, Amarjargal O, et al. Clinical patterns and major causes of infertility in Mongolia. J Obstet Gynaecol Res. 2004;30:386–93. doi: 10.1111/j.1447-0756.2004.00217.x.

Source: PubMed

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