Introduction: Patients increasingly utilize the internet as a primary source of health information. As many subfertile couples do not undergo male partner evaluation by a reproductive urologist, we hypothesized that internet search and referral patterns may contribute to underutilization of reproductive urological evaluation. We examined internet search results to understand the information available to couples searching for a male infertility provider.
Methods: The phrase “male infertility specialist ” was searched in Google (Incognito mode) for all 50 states. The first ten results (i.e. first page) of each search were evaluated for provider type (urology vs obstetrics and gynecology [OBGYN]), level of training (fellowship vs none), male fertility information provided and procedures offered. Websites that were purely informational without any listed providers were excluded. We compared search position rank (1-10) across provider types to determine the likelihood of finding an urologist vs OBGYN.
Results: 421 individual results were identified of whom 232 (55.1%) were OBGYN providers, whereas only 160 (38.0%) results led to a fellowship-trained reproductive urologist. On average, urology providers were ranked higher than OBGYN providers (4.8±3.0 vs 5.5±2.8, p=0.01). Geographic differences in the search results were noted, with a significant association found between state population and percent of results that were urology-related (Spearman’s correlation, p<0.001). Among 232 OBGYN providers, 136 unique practices were identified. The majority of websites for these practices did not mention varicocele repair (86, 63.2%), vasectomy reversal (104, 76.5%), or sperm extraction (70, 51.5%). Among 66 OBGYN websites that did mention sperm extraction, 20 (30.3%) performed sperm extraction in-house, 23 (34.8%) referred to an urologist, and 22 (33.3%) did not specify who performed the procedure
Conclusions: When searching the internet for a male infertility specialist, the majority of results identified OBGYN physicians. Furthermore, a large proportion of OBGYN websites lacked information on important male fertility treatments, and most did not appear to offer these treatments. These data indicate a need for a more robust online presence to optimize online access for subfertile couples. Source of
