Artificial intelligence and clinical guidance in male reproductive health: ChatGPT4.0's AUA/ASRM guideline compliance evaluation.

Background: Male infertility is defined as the inability of a male to achieve a pregnancy in a fertile female by the American Urological Association (AUA) and the American Society for Reproductive Medicine (ASRM). Artificial intelligence, particularly in language processing models like ChatGPT4.0, offers new possibilities for supporting clinical decision-making. This study aims to assess the effectiveness of ChatGPT4.0 in responding to clinical queries regarding male infertility, which is aligned with AUA/ASRM guidelines.

Methods: This observational study employed a design to evaluate the performance of ChatGPT4.0 across 1073 structured clinical queries categorized into true/false, multiple-choice, and open-ended. Two independent reviewers specializing in reproductive medicine assessed the responses using a six-point Likert scale to evaluate accuracy, relevance, and guideline adherence.

Results: In the true/false category, the initial accuracy was 92%, which increased to 94% by the end of the study period. For multiple-choice questions, accuracy improved from 85% to 89%. The most significant gains were seen in open-ended questions, where accuracy rose from 78% to 86%. Initially, some responses did not fully align with the AUA/ASRM guidelines. However, by the end of the 60 days, these responses had become more comprehensive and clinically relevant, indicating an improvement in the model's ability to generate guideline-conformant answers (p < 0.05). The depth and accuracy of responses for higher difficulty questions also showed enhancement (p < 0.01).

Conclusion: ChatGPT4.0 can serve as a valuable support tool in managing male infertility, providing reliable, guideline-based information that enhances the accuracy of clinical decision-making tools and supports patient education.