PD29-04 ACCESS TO CARE FOR INFERTILE MEN: FACTORS INFLUENCING REFERRAL FROM THE REPRODUCTIVE ENDOCRINOLOGIST TO THE UROLOGIST

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD29)1 Sep 2021PD29-04 ACCESS TO CARE FOR INFERTILE MEN: FACTORS INFLUENCING REFERRAL FROM THE REPRODUCTIVE ENDOCRINOLOGIST TO THE UROLOGIST Julie Shabto, Katherine Poulose, Mackenzie Bennett, Angel Xiao, Heather Hipp, Jennifer Kawwass, and Akanksha Mehta Julie ShabtoJulie Shabto More articles by this author , Katherine PouloseKatherine Poulose More articles by this author , Mackenzie BennettMackenzie Bennett More articles by this author , Angel XiaoAngel Xiao More articles by this author , Heather HippHeather Hipp More articles by this author , Jennifer KawwassJennifer Kawwass More articles by this author , and Akanksha MehtaAkanksha Mehta More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002030.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men at risk for subfertility should undergo further evaluation by a urologist, ideally with specialization in male reproduction. We investigated patient access to reproductive urologists by analyzing referral practices of United States (US) assisted reproductive technology (ART) clinics. METHODS: Using 2018 Centers for Disease Control Fertility Clinic Success Rates Reports, we identified 537 ART clinics in the US. We excluded 57 clinics due to permanent closure. We conducted a telephone interview of each clinic using a standard template to determine clinic practices in the management of male factor infertility, including referral to a urologist. Differences in variables were evaluated with respect to clinic location; number of ART clinics located within 50 miles (proxy for population density); practice affiliation; presence of urology fertility fellowship in state; state mandated fertility coverage; number of physicians in practice; total in vitro fertilization (IVF) cycles completed; and percentage of IVF cycles completed for male factor infertility. RESULTS: We interviewed 477 clinics (Table 1). Fifty clinics (10.5%) had an onsite urologist for male fertility treatment, 42 of whom were fellowship-trained in male fertility. An additional 33 clinics (6.9%) had a urologist onsite for surgical procedures, 18 of whom were fellowship-trained in male fertility. Among the 427 clinics without an onsite urologist, 30 did not refer male patients to a urologist. Ninety-two clinics had the reproductive endocrinologists manage male partner’s treatment, including with medication (89, 18.7%) and surgical sperm retrieval (30, 6.3%). Clinics located in urban areas (>7 ART clinics within 50 miles), in states with male fertility fellowship program, larger practices (≥5 physicians or ≥1,000 IVF cycles), those with SART membership, and those with academic affiliation were more likely to refer male partners to a reproductive urologist. CONCLUSIONS: Access to reproductive urologists by referral from reproductive endocrinologists was associated with: urban clinic location, presence of fertility fellowship program in-state, affiliation with an academic center, and higher number of IVF cycles. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e527-e528 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Julie Shabto More articles by this author Katherine Poulose More articles by this author Mackenzie Bennett More articles by this author Angel Xiao More articles by this author Heather Hipp More articles by this author Jennifer Kawwass More articles by this author Akanksha Mehta More articles by this author Expand All Advertisement Loading ...