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

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.

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

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