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Diagnostic and therapeutic workup of male infertility: results from a Delphi consensus panel

International Journal of Impotence Research volume 35, pages 1–13 (2023)Cite this article

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A Correction to this article was published on 04 March 2022

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Abstract

Male factor infertility (MFI) is a rising issue worldwide with significant socioeconomic costs and negative psychological consequences for the couple. Current guidelines provide recommendations for its diagnosis and treatment but several gaps in the management of MFI are encountered in clinical practice due to the lack of available evidence in published literature. Uncertainty in the management of MFI cases leads to a high degree of variability in therapeutic approaches. We planned a Delphi consensus method to provide insights and help bridge the gaps that separate clinical guidelines from real-world practice. The Advisory Board collected 41 statements on debated topics in the management of MFI, each including multiple items designed as a 5-point Likert scale. The questionnaire was sent by e-mail to a panel of Italian experts for a first round of voting; members of the panel were later invited to a second round of voting, preceded by discussion of the “hot topics” identified in the first round. At both rounds of the Delphi consensus 68 experts participated to the voting process. After the first round 25 statements were identified as hot topics, and these underwent the second round of voting. Consensus was reached on many, but not all cases, leaving vagueness on few debated topics where decisions are unsupported by clinical studies or driven by controversial results. In conclusion, indications emerging from this large panel of experts may help guide the management of male factor infertility in clinical practice. Studies are needed to address unanswered questions left by cases for whom no consensus was reached.

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Acknowledgments

Authors want to acknowledge all collaborators who completed the questionnaire during the first and second round of voting: Paolo Turchi, Gianmartin Cito, Ilaria Natali, Alessandro Natali, Antonio Corvasce, Lucilla Divenuto, Stefano Impedovo, Michele Tedeschi, Francesco Paolo Turri, Antonio Vavallo, Antonio Vitarelli, Francesco Sebastiani, Davide Arcaniolo, Francesco Bottone, Francesco Chiancone, Lorenzo Cirigliano, Michelangelo Sorrentino, Giuseppina Peluso, Ottavio Sicuro, Pietro Paolo Cozza, Manuela Andreozzi, Marco Bitelli, Giorgio Franco, Vincenzo Gentile, Giuseppe La Pera, Andrea Ortensi, Pietro Salacone, Federica Sanna, Giovanni Tuffo, Paola Asero, Danilo Di Trapani, Vincenzo Favilla, Ignazio Gattuccio, Emilio Italiano, Bruno Giammusso, Filippo Montalto, Paolo Panella, Salvatore Privitera, Pietro Russo, Giuseppe Sidoti, Andrea Fabiani, Giorgio Gentile, Alessandro Franceschelli, Carlo Maretti, Edoardo Pescatori, Pasquale Scarano, Massimo Polito, Luigi Quaresima, Andrea Salonia, Gaetano Donatelli, Antonio Avolio, Daniele Tiscione, Andrea Galantini, Matteo Titta, Giorgio Piubello, Luca Boeri, Massimo Iafrate, Filippo Migliorni, Giovanni Liguori, Gioacchino De Giorgi, Emanuele Baldassarre, Giorgio Del Noce, Michele Manica, Carla Pasquale, Maurizio Ruggieri, Paolo Capogrosso, Fabrizio Ildefonso Scroppo, Elisabetta Micelli, Michele Rizzo.

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Authors and Affiliations

  1. Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

    Luca Boeri & Andrea Salonia

  2. Department of Urology, Foundation IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Luca Boeri

  3. Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy

    Paolo Capogrosso

  4. Laboratory Altamedica, Rome, Italy

    Ilaria Ortensi

  5. Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy

    Carlos Miacola

  6. Department of Urology, Santa Chiara Regional Hospital, Trento, Italy

    Tommaso Cai

  7. Urology Unit, Department of Medicine, Surgery, Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy

    Paolo Verze

  8. Urology Clinic, Policlinic “Morgagni”, Catania, Italy

    Bruno Giammusso

  9. Department of Urology, University of Naples, Federico II, Naples, Italy

    Alessandro Palmieri

Authors
  1. Luca Boeri
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  2. Paolo Capogrosso
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  3. Ilaria Ortensi
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  4. Carlos Miacola
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  5. Tommaso Cai
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  6. Paolo Verze
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  7. Andrea Salonia
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  8. Bruno Giammusso
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  9. Alessandro Palmieri
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Contributions

LB was responsible for designing the protocol, collecting data, interpreting results and drafting the manuscript. PC was responsible for designing the protocol, collecting data, interpreting results. IO was responsible for designing the protocol, collecting data, interpreting results. CM was responsible for designing the protocol, collecting data, interpreting results. TC was responsible for designing the protocol, collecting data, interpreting results lts. PV was responsible for designing the protocol, collecting data, interpreting results. AS was responsible for designing the protocol, collecting data, interpreting results. BG was responsible for designing the protocol, collecting data, interpreting results. AP was responsible for designing the protocol, collecting data, interpreting results.

Corresponding author

Correspondence to Luca Boeri.

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The original online version of this article was revised to add acknowledgments.

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Boeri, L., Capogrosso, P., Ortensi, I. et al. Diagnostic and therapeutic workup of male infertility: results from a Delphi consensus panel. Int J Impot Res 35, 1–13 (2023). https://doi.org/10.1038/s41443-021-00511-x

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  • DOI: https://doi.org/10.1038/s41443-021-00511-x

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