To examine the occurrence of low testosterone levels in infertile men with normal sperm concentration and to ascertain the percentage who have not undergone endocrinological evaluation, highlighting the clinical significance of these findings.
Key Findings:
77.2% of the 3,147 males did not receive hormonal assessment.
Endocrine evaluation rates varied significantly by medical specialty: 100% for urologists trained in male infertility, 23.2% for general urologists, and 1.2% for gynecologists.
24.1% of the 718 males who underwent hormonal evaluation exhibited low testosterone levels.
Increased BMI (OR 1.083, 95% CI 1.031–1.136) and decreased estradiol (OR 0.956, 95% CI 0.937–0.976) were identified as independent predictors of low testosterone.
Interpretation:
The study highlights a significant screening deficiency for low testosterone in normozoospermic infertile males, emphasizing the need for routine endocrine assessments regardless of sperm count, particularly in those with obesity, to improve fertility outcomes.
Limitations:
Retrospective design may limit causal inferences and introduce selection bias.
Single-center study may affect generalizability.
Conclusion:
The findings underscore the importance of endocrine evaluation in infertile males with normal sperm concentrations, as low testosterone is a manageable condition that could improve fertility outcomes, warranting routine screening.
