Temporal and geospatial trends in male factor infertility with assisted reproductive technology in the United States from 1999-2010

Objective: To estimate the prevalence of male factor infertility diagnosis within the context of assisted reproductive technology (ART) clinics and its geographic and temporal distribution from 1999-2010. Design: Population study based on patients presenting for care at ART centers. Setting: Clinics providing ART services. Patient(s): All male patients seeking infertility care at ART clinics. Intervention(s): Data were obtained from the Centers for Disease Control and Prevention, analyzed, geocoded, and mapped. Main Outcome Measure(s): Prevalence of male factor infertility diagnosis in a couple seeking infertility care. Result(s): Between 1999 and 2010, 1,057,402 cycles of ART using nonfrozen, nondonor eggs were performed, increasing from 62,809 cycles in 1999 to 99,289 cycles in 2010. Nationwide in ART clinics, the period prevalence of isolated male factor infertility was 17.1% and the prevalence of overall male factor infertility diagnoses was 34.6%. The highest prevalence was reported in New Mexico (56.4%) and lowest in Mississippi (24.2%). Conclusion(s): The prevalence of male factor infertility diagnosis varies significantly by time and space within the United States, whereas its overall prevalence has remained remarkably stable. This study provides the spatial analytic framework for future research to explore factors associated with male factor infertility. (C) 2014 by American Society for Reproductive Medicine.