Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I


      The summary presented herein represents Part I of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part I outlines the appropriate evaluation of the male in an infertile couple. Recommendations proceed from obtaining an appropriate history and physical exam (Appendix I), as well as diagnostic testing, where indicated.


      The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January, 2000 through May, 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. (Table 1) This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology.


      This Guideline provides updated, evidence-based recommendations regarding evaluation of male infertility as well as the association of male infertility with other important health conditions. The detection of male infertility increases the risk of subsequent development of health problems for men. In addition, specific medical conditions are associated with some causes for male infertility. Evaluation and treatment recommendations are summarized in the associated algorithm. (Figure 1)


      The presence of male infertility is crucial to the health of patients and its effects must be considered for the welfare of society. This document will undergo updating as the knowledge regarding current treatments and future treatment options continues to expand.
      Diagnóstico y tratamiento de la infertilidad masculina: guía de la AUA/ ASRM parte 1.


      El resumen representa la Parte I de una serie de dos partes dedicada al diagnóstico y tratamiento de la infertilidad masculina: Guía de la AUA/ASRM. La primera parte describe la evaluación apropiada del hombre en una pareja infértil. Las recomendaciones pasan por la realización de una historia y un examen físico apropiados (Apéndice I), así como pruebas de diagnóstico, cuando esté resulte indicado.


      El equipo del Centro de Práctica Basada en la Evidencia del Instituto de Investigación de Cuidados de Emergencia buscó en PubMed, Embase y Medline desde enero de 2000 hasta mayo de 2019. Cuando existían pruebas suficientes, se asignaba al conjunto de pruebas una calificación de A (alta), B (moderada) o C (baja) para el apoyo de las recomendaciones fuertes, moderadas o condicionales. En ausencia de pruebas suficientes, se proporciona información adicional en forma de Principios Clínicos y Opiniones de Expertos. (Cuadro 1). Este resumen se publica simultáneamente en Fertility and Sterility y The Journal of Urology.


      Esta guía proporciona recomendaciones actualizadas y basadas en la evidencia sobre la evaluación de la infertilidad masculina, así como la asociación de la infertilidad masculina con otras condiciones de salud importantes. La detección de la infertilidad masculina aumenta el riesgo de posterior desarrollo de los problemas de salud de los hombres. Además, determinadas afecciones médicas se asocian con algunas causas de la infertilidad masculina. La evaluación y las recomendaciones de tratamiento se resumen en el algoritmo asociado. (Figura 1)


      La presencia de la infertilidad masculina es crucial para la salud de los pacientes y sus efectos deben ser considerados para el bienestar de sociedad. Este documento se actualizará a medida que continúe el conocimiento sobre los tratamientos actuales y las opciones de tratamiento futuras para expandirse.


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