Published In: Urologic Diseases In America / Edited By Mark S. Litwin and Christopher S. Saigal (Washington, D.C.: US Department of Health and Human Services, Public Health, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2007), Chapter 14, p. 461-481, NIH Pub. no. 07-5512
Posted on RAND.org on December 31, 2006
Male infertility presents a particularly vexing clinical problem. While the patient's semen may seem to be the target for diagnostic and therapeutic interventions and analysis, a positive outcome is in fact manifested by another person, a mother, giving birth to a child. And whereas presence of offspring is the ultimate proof of male reproductive health, the manner in which outcomes are expressed in this area are perhaps the most sensitive in medicine to probabilistic statements. For example, outcomes of artificial reproductive techniques are expressed in probabilities, such as the take-home baby rate, the likelihood per intervention that a particular therapy will result in a live birth. For these reasons, epidemiologic statements regarding male reproductive dysfunction present formidable challenges, and the patients undergoing diagnosis and treatment for infertility are often understandably confused.