Perceptions of Infertility and Semen Analysis Testing Among American Men Without Children.

To determine whether health-conscious men are more likely to be concerned about infertility and self-initiate semen analysis at a laboratory/clinic or through a direct-to-consumer at-home product without a health care provider recommendation.

Cross-sectional survey conducted online via ResearchMatch.org between November 2019 and January 2020. Men age 18 and older without children (n=634) were included for analysis. Outcomes were likelihood of self-initiating a semen analysis, prevalence of infertility concern.

Of the 634 participants, 186 expressed concern about infertility but only 29% were likely to discuss these concerns with a health care provider. More men would self-initiate a semen analysis using an at-home product than through a traditional laboratory/clinic (14.2% vs 10.4%, p=0.04). Odds of self-initiating a traditional semen analysis were higher for men concerned about low testosterone (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.12-4.74, p=0.023) and infertility (OR 3.91, 95% CI 2.14-7.15, p<0.001). Self-initiating an at-home semen analysis was associated with concern for low testosterone and infertility as well as middle age (age 40-59: OR 3.02, 95% CI 1.16 to 7.88, p=0.024) and fitness tracker use (OR: 1.95, 95% CI 1.12 to 3.39, p=0.018).

Many men were unlikely to discuss infertility concerns with a health care provider. Middle aged men and those who used fitness trackers were more likely to self-initiate fertility evaluation through at-home semen analysis. Concern about low serum testosterone was pervasive and strongly associated with concern for being infertile and self-initiating a semen analysis of any kind.

Urology. 2021 Sep 16 [Epub ahead of print]

Matthew T Hudnall, Lisa I Greene, Minh N Pham, Jeremy D Lai, Richard J Fantus, Mary Kate Keeter, James Wren, Nelson E Bennett, Robert E Brannigan, Joshua A Halpern

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: ., Northwestern University Feinberg School of Medicine, Chicago, IL., Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.