The Racial and Socioeconomic Characteristics of Men Using Mail-in Semen Testing Kits in the United States

Nicholas Sellke; Jad Badreddine; Stephen Rhodes; Nannan Thirumavalavan; Ramy Abou Ghayda

doi:10.1016/j.urology.2023.07.023

The Racial and Socioeconomic Characteristics of Men Using Mail-in Semen Testing Kits in the United States

Urology. 2023 Oct:180:135-139. doi: 10.1016/j.urology.2023.07.023. Epub 2023 Aug 3.

Authors

Nicholas Sellke¹, Jad Badreddine², Stephen Rhodes², Nannan Thirumavalavan³, Ramy Abou Ghayda³

Affiliations

¹ Case Western Reserve University School of Medicine, Cleveland, OH; Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, OH. Electronic address: Nicholas.sellke@uhhospitals.org.
² Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, OH.
³ Case Western Reserve University School of Medicine, Cleveland, OH; Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, OH.

PMID: 37543117
DOI: 10.1016/j.urology.2023.07.023

Abstract

Objective: To describe the racial and socioeconomic characteristics of men using mail-in semen testing kits for their fertility care in the United States over 3 years.

Methods: A cross-sectional analysis was conducted of men who used mail-in semen analyses from a single direct-to-consumer (DTC) fertility platform between 2020 and 2022. Age, race/ethnicity, place of residence, and education level of men using mail-in semen analysis kits was collected from user questionnaires. Zip code level socioeconomic status was estimated using the Area Deprivation Index (ADI). These characteristics were compared to the overall population of the United States.

Results: 4342 men used mail-in semen analyses from a single DTC fertility company between 2020 and 2022 and completed the questionnaire. The median age of this cohort was 36 (IQR: 32,40) years. The group consisted of predominantly white men (72%), with 7.9% Asian and only 5.1% Black, 3.2% Hispanic, 0.4% Indian American, 0.1% pacific islander, 5.8% mixed race, and 2.8% other groups. 45.8% of the group had completed college, 22% had a master's degree, and 9% had a doctoral degree. The mean ADI was 83.47 (SD 21.44) compared to the average ADI of 100 for the general US population (P < .005).

Conclusion: DTC mail-in semen analyses have the potential to improve access to affordable fertility care. Racial and ethnic minorities and lower socioeconomic classes are underrepresented for men seeking DTC fertility testing as they are for men presenting for in-office fertility care. Additional studies are needed to determine the factors responsible for these discrepancies.