Trak’s Fertility Risk Assessment Quiz Helps Predict Infertility in Men – 2018 AUA Meeting

EVALUATION OF A PRECONCEPTION MALE FERTILITY RISK ASSESSMENT SCORING ALGORITHM WITH MEN ACTIVELY TRYING TO CONCEIVE

Trak and our collaborators presented a statistical assessment of data gathered through our proprietary Male Fertility Risk Assessment Quiz at the 2018 American Urological Association (AUA) annual meeting. See the Journal of Urology for full text.

AUTHORS

Laura Fredriksen, Ulrich Schaff, Sara Naab, Kirk Harmon, April Culver, Raymond Naval, Jesper Verhey, Michael Eisenberg, and Greg Sommer

INTRODUCTION AND OBJECTIVES

General health and lifestyle factors can impact male reproductive health. In May 2015 we launched a 30-question online fertility risk assessment questionnaire of established male fertility risk factors based on a literature review, including age, body size, medical history, diet, exercise, sleep, and exposure to known toxins. A summary ″risk score″ was calculated by weighting responses from each man based on literature studies and a priori assumptions on risk of male infertility, subfertility, and sperm quality. The current study evaluates the correlation between the risk score and respondents′ time trying to conceive (TTC).

METHODS

Anonymized responses to the free online risk assessment questionnaire were compiled and analyzed. Risk scores were normalized on a scale of -30 to 100 and correlated with TTC using ordinal logistic regression and binomial logistic regression models. 1-way ANOVA or t-test was used to evaluate risk score differentiability between TTC category response groups divided into four categories (< 6 mo, 6-12 mo, 12-24 mo, and ≥ 24 mo).

RESULTS

As of August 2017, 10,237 total responses were gathered, of which 6,945 men were actively trying to conceive. The average age of the respondents was 34 (± 8.5 years). Using 1-way ANOVA of the risk scores for each TTC category show a significant difference between groups (p < 0.0001), with the average risk scores generally increasing for increasing TTC. The average score for the < 6 mo group was 4.7, 6-12 mo was 4.6, 12-24 mo was 8.6, and ≥ 24 mo was 10.2. For each 10 unit increase in the risk score, the odds of being in a longer TTC group increased by a factor of 11.1 (95% CI 11.0 – 11.2). Using 2-category TTC discrimination (< 12 mo or ≥ 12 mo), 2-sided t-test of the risk scores show a significant difference between the two TTC groups (p < 0.0001). The average score for the <12 mo group was 4.7 and the ≥12 mo group was 9.4. Additionally, from the binomial logistic regression model, we were able predict probability of clinical infertility (≥ 12 mo TTC) given the preliminary risk score, with an AUC of 0.73.

CONCLUSIONS

The analysis demonstrated an association between a priori assumptions of men′s health and lifestyle risk factors and TTC. By demonstrating predictive power, this preliminary risk assessment tool may help engage men earlier in the conception process with health and lifestyle changes in addition to improving access to specialized care. Further analysis of correlations with specific risk factors such as BMI, smoking, diet, exercise, and other exposures is needed.

Journal of Urology, April 2018, Volume 199, Issue 4, Supplement, Page e222