Infertility knowledge and awareness in men presenting for infertility evaluation: a cross-sectional study from a urology outpatient clinic

Conocimientos y concientización sobre la infertilidad en hombres que acuden a una evaluación de infertilidad: un estudio transversal de una consulta externa de urología

Background: Public awareness of infertility remains suboptimal, and most existing studies focus predominantly on women. This study evaluated men’s knowledge and awareness of infertility at a tertiary urology outpatient clinic. Methods: This cross-sectional study enrolled 327 married men of reproductive age who sought evaluation for infertility. Participants completed a 16-item binary (yes/no) questionnaire assessing basic concepts of reproduction, infertility definitions, and lifestyle-related risk factors. Participants were grouped based on educational level (below vs. university level and above) and history of assisted reproductive techniques (ART). All responses were analyzed both at the overall cohort level and separately within each subgroup. Results: Only 55% of the participants correctly identified the World Health Organization (WHO) definition of infertility. Patients who sought evaluation before completing 12 months of unprotected intercourse demonstrated lower awareness of both the definition of infertility and the expected 12-month pregnancy rate (p = 0.027, p = 0.003, respectively). Knowledge that the probability of pregnancy increases to approximately 80% after 12 months of unprotected intercourse was significantly higher among participants with a history of ART (71.0% vs. 53.8%, p = 0.005). Men with a university-level education demonstrated significantly better knowledge regarding ovulation timing, fertilisation, and male contribution to infertility. The majority of respondents (80.7%) relied on Google as their primary source of infertility-related information, with men of lower educational attainment demonstrating greater reliance on online sources compared with their more highly educated counterparts. Conclusions: Men presenting for infertility evaluation exhibited limited knowledge of infertility, particularly regarding its formal definition and key aspects of reproductive physiology. Higher education and prior ART experience were associated with improved knowledge, although this did not consistently translate into healthier lifestyle behaviours. These findings underscore the importance of targeted infertility education for men, particularly through accurate, evidence-based, and accessible digital resources.

Resumen

Antecedentes: La concienciación pública sobre la infertilidad sigue siendo subóptima, y la mayoría de los estudios existentes se centran predominantemente en las mujeres. Este estudio evaluó el nivel de conocimiento y concienciación sobre la infertilidad en hombres que acudieron a una consulta ambulatoria de urología de tercer nivel. Métodos: Este estudio transversal incluyó a 327 hombres casados en edad reproductiva que acudieron para evaluación por infertilidad. Los participantes completaron un cuestionario de 16 ítems con respuestas binarias (sí/no), que evaluaba conceptos básicos sobre reproducción, definiciones de infertilidad y factores de riesgo relacionados con el estilo de vida. Los participantes fueron clasificados según su nivel educativo (inferior a universitario vs. universitario o superior) y antecedentes de técnicas de reproducción asistida. Todas las respuestas fueron analizadas tanto a nivel global como dentro de cada subgrupo. Resultados: Solo el 55% de los participantes identificó correctamente la definición de infertilidad según la Organización Mundial de la Salud (OMS). Los pacientes que buscaron evaluación antes de completar 12 meses de relaciones sexuales sin protección mostraron menor conocimiento tanto sobre la definición de infertilidad como sobre la tasa de embarazo esperada a los 12 meses (p = 0.027 y p = 0.003, respectivamente). El conocimiento de que la probabilidad de embarazo aumenta aproximadamente al 80% después de 12 meses sin protección fue significativamente mayor entre los participantes con antecedentes de técnicas de reproducción asistida (TRA) (71.0% vs. 53.8%, p = 0.005). Los hombres con nivel educativo universitario demostraron un conocimiento significativamente mejor sobre el momento de la ovulación, la fecundación y la contribución masculina a la infertilidad. La mayoría de los encuestados (80.7%) utilizó Google como su principal fuente de información sobre infertilidad, siendo los hombres con menor nivel educativo quienes mostraron una mayor dependencia de fuentes en línea en comparación con aquellos con mayor nivel de estudios. Conclusiones: Los hombres que acudieron a evaluación por infertilidad presentaron conocimientos limitados sobre esta condición, especialmente en lo relacionado con su definición formal y aspectos clave de la fisiología reproductiva. Un mayor nivel educativo y antecedentes de tratamiento con técnicas de reproducción asistida (TRA) se asociaron con un mejor conocimiento, aunque esto no se tradujo de manera consistente en comportamientos de estilo de vida más saludables. Estos hallazgos subrayan la importancia de implementar estrategias educativas dirigidas a los hombres sobre infertilidad, especialmente a través de recursos digitales precisos, basados en evidencia y de fácil acceso.

Infertility; Male reproductive health; Fertility awareness; Assisted reproductive techniques; Health literacy

Palabras Clave

Infertilidad; Salud reproductiva masculina; Conocimiento sobre fertilidad; Técnicas de reproducción asistida; Alfabetización en salud

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