Evidence map›Paper›PMID 30359710›Full record

ArticleUrology2019

An Infertile Couple's Long and Expensive Path to Varicocele Repair.

Adithya Balasubramanian, Nannan Thirumavalavan, Jason M Scovell, Jonathan Lo, Byung Ji, Elizabeth L Godfrey, Alexander W Pastuszak, Larry I Lipshultz

Open access · greenAbstract read
In one paragraph

Article in Urology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Adithya BalasubramanianCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Nannan ThirumavalavanCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX. Electronic address: nannan@bu.edu.
Jason M ScovellCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Jonathan LoCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Byung JiCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Elizabeth L GodfreyCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Alexander W PastuszakCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Larry I LipshultzCenter for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Baylor College of Medicine · US

Funding

Multidisciplinary K12 Urologic Research (KURe) Career Development ProgramK12DK083014 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI LAMB, DOLORES JEAN · 2008 to 2017
$6.0M
Training Program in Translational Biology and Molecular MedicineT32GM088129 · NIGMS · BAYLOR COLLEGE OF MEDICINE · PI ROONEY, CLIONA M., VAN DEN VEYVER, IGNATIA B · 2010 to 2019
$3.0M
Characterization of the Role of NELL1 in the Predisposition to Peyronie's and Dupuytren's Diseases.K08DK115835 · NIDDK · UNIVERSITY OF UTAH · PI PASTUSZAK, ALEXANDER WOJCIECH · 2018 to 2020
$490k
NIDDK NIH HHS K08 DK115835NIDDK NIH HHS K12 DK083014NIGMS NIH HHS T32 GM088129
6 · The paper itself

Abstract

objectiveTo characterize the pathways to care that infertile couples requiring varicocele repair (VR) pursue prior to presenting to a male fertility clinic.

methodsAn IRB-approved single center retrospective review of patients undergoing VR after presentation to an academic male fertility clinic was performed. Patients whose charts included partner histories were assessed for duration of attempting conception, prior workup, and assisted reproductive technology (ART) use.

resultsA total of 405 couples were included. At presentation, mean age was 34.4 (SD ± 6.5) years for men and 31.1 (SD ± 4.3) years for women (P < .0001). A couple's first visit to a physician was a gynecologist in 59% (198/334) of couples, a reproductive endocrinologist (REI) in 25% (83/334) of cases, with 14% (47/334) presenting without a previous female workup and were self-referred, and 2% (6/334) seeing both a gynecologist and REI prior to presentation. On average, couples attempted pregnancy for 22.3 (SD ± 21.1, range 0-120) months prior to presentation. Eighteen percent of couples underwent ART prior to presentation. Couples who had undergone ART had lower pre-VR total motile sperm counts compared to couples not pursuing ART prior to presentation (P = 0.031). The majority (70.4%) of females had no abnormality in their workup, making varicocele the only correctable factor for infertility in the couple.

conclusionsOur findings show a significant delay in referral of infertile men requiring VR. Eighteen percent of couples underwent costly ART prior to an inexpensive male workup. In an era of medical cost containment, early referral to a male infertility specialist is imperative.

Indexed as

AdolescentAdultCritical PathwaysFemaleHumansInfertility, MaleMaleMiddle AgedReferral and ConsultationRetrospective StudiesTime-to-TreatmentUrologic Surgical Procedures, MaleVaricoceleYoung Adult

Identifiers

PMID30359710
PMCPMC6387868
OpenAlexW2897241381

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.