Neil Osterweil

May 21, 2014

ORLANDO, Florida — Congenital abnormalities in children conceived with assisted reproductive technologies do not appear to be related to the quality of the father's semen, results from a new study suggest.

"The severity of the male-factor infertility might not actually affect the rate of congenital abnormalities," said Alexander Pastuszak, MD, PhD, a urology resident at Baylor College of Medicine in Houston.

This leads to the possibility that the technique itself — in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) — is a risk factor for congenital anomalies, he said.

The use of assisted reproductive technology has doubled in the United States over the past 10 years, and the risk for birth defects is elevated in children conceived through IVF or ICSI, said Dr. Pastuszak.

Because men with low sperm counts are at increased risk of having sperm with chromosomal abnormalities, we wanted to determine whether birth defects in children conceived with assisted reproduction techniques could be attributed to semen quality, he explained.

Dr. Pastuszak presented the results here at the American Urological Association 2014 Annual Scientific Meeting.

Linked Data

Dr. Pastuszak and colleagues used the Baylor College of Medicine Semen Database, which collects information on men who come to Baylor for reasons other than vasectomy (presumably infertility counseling and treatment).

Records that contained complete semen parameters were linked to records in the Texas Birth Defects Registry from 1999 to 2009.

Records for 6087 men were linked to 7538 live births. In this cohort, 373 (4.9%) children were born with 1 or more congenital abnormalities.

Only multiple births and preterm birth were significantly associated with birth defects (< .0001 for both).

There were no significant associations between birth defects and paternal or maternal demographic characteristics, including age, race/ethnicity, level of education, or parent's birthplace.

When the researchers looked at specific semen parameters, such as concentration, motility, and volume, they could not find any significant associations with birth defects.

"Now we're working to evaluate whether the mode of conception — natural vs artificial — is more closely related to semen parameters and birth defects," Dr. Pastuszak said.

The findings should be reassuring to men with a low sperm count or other abnormal semen parameters, but could raise concerns for some patients about assisted reproductive techniques, said briefing moderator Tobias Köhler, MD, MPH, associate professor of urology at Southern Illinois University School of Medicine in Springfield, who was not involved in the study.

"What this study says is that just because you have a low sperm count, just because your semen analysis is abnormal, that doesn't mean you're going to have a child with a birth defect," he stated.

"But if you have to use these assisted reproductive techniques, this study says that there may be a problem," Dr. Köhler explained.

"When we use assisted reproductive technologies, we kind of bypass nature's breaks and control mechanisms, so it kind of makes sense that there are going to be some repercussions," he added.

The study was internally supported. Dr. Pastuszak and Dr. Köhler have disclosed no relevant financial relationships.

American Urological Association (AUA) 2014 Annual Scientific Meeting: Abstract MP68-02. Presented May 20, 2014.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.