title: Temporal and geospatial trends in male factor infertility with assisted reproductive technology in the United States from 1999-2010.
abstract: 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.
  
  
  METHODS
  Population study based on patients presenting for care at ART centers.
  
  
  METHODS
  Clinics providing ART services.
  
  
  METHODS
  All male patients seeking infertility care at ART clinics.
  
  
  METHODS
  Data were obtained from the Centers for Disease Control and Prevention, analyzed, geocoded, and mapped.
  
  
  METHODS
  Prevalence of male factor infertility diagnosis in a couple seeking infertility care.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, California.
authors.forename: Anobel Y
authors.initials: AY
authors.lastname: Odisho
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Nangia
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, California; Department of Medicine and Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Katz
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, California; Department of Obstetrics, Gynecology, and Reproductive Sciences and Institute for Health Policy, University of California, San Francisco. Electronic address: smithjf@urology.ucsf.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Smith
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D015995:Prevalence; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000639:trends*; D012111:Residence Characteristics; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: GIS; Male factor infertility; geospatial mapping; health services; prevalence