Mp13-08 Fertility Outcomes Across the Rural-Urban Continuum

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP13)1 May 2024MP13-08 FERTILITY OUTCOMES ACROSS THE RURAL-URBAN CONTINUUM Devon M. Langston, Kiarad Fendereski, Joshua Halpern, Ijeoma Ika, Kenneth Aston, Elizabeth Ferlic, Ben Emery, Joemy M. Ramsay, Joshua Horns, and James Hotaling Devon M. LangstonDevon M. Langston , Kiarad FendereskiKiarad Fendereski , Joshua HalpernJoshua Halpern , Ijeoma IkaIjeoma Ika , Kenneth AstonKenneth Aston , Elizabeth FerlicElizabeth Ferlic , Ben EmeryBen Emery , Joemy M. RamsayJoemy M. Ramsay , Joshua HornsJoshua Horns , and James HotalingJames Hotaling View All Author Informationhttps://doi.org/10.1097/01.JU.0001008832.14212.d6.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Infertility impacts approximately 20% of couples due to male factors alone. The gold standard for assessing male factor infertility (MFI) is a semen analysis (SA) to identify sperm defects that inhibit conception via intercourse. Studies have identified factors influencing male factors including socioeconomic status, but the impact of rurality residence on male factors is underexplored. Our aim was to examine the differences in fertility outcomes among sub-fertile males across the Rural—Urban continuum. METHODS: Our male patient cohort was identified using the Utah Population Database (UPDB), which combines demographic, medical, and residential data for patients residing in Utah. We linked patients to the Subfertility Health Assisted Reproduction and Environment (SHARE) database, which houses fertility data for 13,873 men in our final cohort who underwent semen analysis between 1998-2017. The data was divided by metropolitan (metro-) [large, medium, small], and non-metropolitan (non-metro-) [urban, rural] status, based on United States Department of Agriculture (USDA) rural-urban continuum codes (RUCC). RESULTS: Non-metro urban/rural males were less likely to be racial minority (91.3% non-Hispanic white vs 85.7%), and less likely to use assisted reproductive technology (ART) (13.4% vs 18.5%), intrauterine insemination (IUI) or in vitro fertilization (IVF) (8.0% vs 10.4% and 5.5% vs 8.1%; all comparisons p<0.001). In a multivariate regression controlling for race/ethnicity, age, semen analysis category (oligozoospermic vs normozoospermic), previous successful fertility outcome, and use of ART, completely rural area of residence was significantly associated with decreased likelihood of successful fertility outcome compared to metropolitan individuals (Hazard Ratio [HR] 0.63, 95% CI 0.44–0.91, n=65). Non-metro urban individuals also trended towards lower likelihood of successful fertility outcome ([HR] 0.93, 95% CI 0.85–1.01). Interestingly, completely rural area of residence is associated with longer median time to successful fertility outcome and lower total percent success. CONCLUSIONS: Rural area of residence significantly decreases likelihood of successful fertility outcomes in a statewide patient database of men undergoing semen analysis for fertility assessment. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e213 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Devon M. Langston More articles by this author Kiarad Fendereski More articles by this author Joshua Halpern More articles by this author Ijeoma Ika More articles by this author Kenneth Aston More articles by this author Elizabeth Ferlic More articles by this author Ben Emery More articles by this author Joemy M. Ramsay More articles by this author Joshua Horns More articles by this author James Hotaling More articles by this author Expand All Advertisement PDF downloadLoading ...