Geographical Differences in Demographics and Fertility Histories of Men Presenting for Infertility Evaluation Between the United States and Canada: Results from the Andrology Research Consortium

The study surveyed 6,462 men from the United States (10%) and Canada (90%) to compare their demographics, clinical characteristics, and fertility histories. The mean age was 36.6 years. The mean duration of infertility was significantly higher in US men (4.5 years) compared to Canadian men (3.6 years). More men in the US were obese (63% vs. 26%). American men were more commonly self-referred (17% vs. 1%) and less frequently referred by a reproductive endocrinologist (54% vs. 68%) to a reproductive urologist compared to men in Canada. American men also less frequently had a semen analysis at the time of presentation (80% vs. 88%). Rates of assisted reproductive technology use were significantly different between the US and Canada. Significant differences were found in smoking history (10% vs. 17%), alcohol use (88% vs. 79%), and marijuana use (9% vs. 18%) amongst men in US and Canada, respectively. Finasteride (3% vs. 0%) and testosterone usage (4% vs. 1%) were more common among US men versus Canadians. The study concluded that American men are older and more obese compared to those in Canada, have a longer mean duration of infertility, and different modifiable lifestyle factors.