A systematic review of interventions to improve male knowledge of fertility and fertility-related risk factors

Male infertility is a global health concern. The effectiveness of interventions developed to improve males’ knowledge of fertility regulation and fertility-related risk factors remains unclear. This systematic review aimed to synthesize and evaluate the evidence for these interventions. Four databases were searched from inception to June 2023. Eligible studies examined interventions to increase fertility knowledge among presumed fertile males aged ≥16 years of age. Conference abstracts, protocols and studies without sex-disaggregated results for males were excluded. A narrative synthesis without meta-analysis was performed. A total of 4884 records were identified. Five studies (reported in six publications), all conducted in high-income countries, were included. Two were randomized control trials, and three were experimental studies. Interventions were delivered in person by a health professional (n = 3), online and via a mobile app. All studies showed a significant improvement in knowledge of fertility or fertility-related risk factors from baseline to follow-up. The largest improvement was observed for secondary and vocational students. A moderate, long-term retainment of knowledge was observed at two-year follow-up in one study. Available evidence suggests interventions to improve males’ fertility knowledge are effective, particularly for younger, less educated males.

男性不育是一项全球性公共卫生问题。目前旨在提升男性生育调控知识及生育相关风险因素认知水平的各类干预措施，其实际应用效果仍未明确。本系统综述（systematic review）旨在综合并评估此类干预措施的相关研究证据。本研究检索了4个数据库自建库至2023年6月的全部文献，纳入标准的研究需针对年龄≥16岁、被认定具备生育能力的男性，评估其接受提升生育知识干预措施后的效果；同时排除会议摘要、研究方案以及未按性别拆分男性相关结果的研究。本次综述采用未进行荟萃分析（meta-analysis）的叙述性综合分析方法。最终共检索到4884条文献记录，最终纳入5项研究（对应6篇已发表文献），所有研究均在高收入国家开展，其中2项为随机对照试验（randomized control trial），3项为实验性研究。干预实施方式包括由医疗专业人员线下开展（共3项）、线上平台及移动应用程序三种形式。所有研究均显示，从基线至随访阶段，受试者在生育知识或生育相关风险因素认知方面均获得显著提升，其中中等教育及职业院校学生的认知提升幅度最大；另有1项研究在2年随访阶段观察到，受试者对所学知识存在中等程度的长期留存效果。现有研究证据表明，提升男性生育认知的干预措施具备有效性，尤其针对年轻、受教育程度较低的男性群体效果更为显著。