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Testosterone replacement therapy in men who conceived with intracytoplasmic sperm injection: nationwide register study

Elenkov, Angel LU ; Al-Jebari, Yahia LU ; Lundberg Giwercman, Yvonne LU and Giwercman, Aleksander LU (2020) In European Journal of Endocrinology
Abstract
Objectives
Male hypogonadism is associated with higher risk of co-morbidity and premature mortality. It is, therefore, of utmost importance to identify young men who are at the highest risk of testosterone deficiency and who may benefit from preventive measures. In this context, infertile men constitute a high-risk group. The extent of testosterone replacement therapy (TRT) among infertile men, defined as men who have to undergo assisted reproduction for fatherhood, is currently unknown. Therefore, we evaluated the pattern of prescription of TRT in the years following child conception among men who have fathered children with the help of intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF).

Design
By... (More)
Objectives
Male hypogonadism is associated with higher risk of co-morbidity and premature mortality. It is, therefore, of utmost importance to identify young men who are at the highest risk of testosterone deficiency and who may benefit from preventive measures. In this context, infertile men constitute a high-risk group. The extent of testosterone replacement therapy (TRT) among infertile men, defined as men who have to undergo assisted reproduction for fatherhood, is currently unknown. Therefore, we evaluated the pattern of prescription of TRT in the years following child conception among men who have fathered children with the help of intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF).

Design
By sourcing data from national population registries, hazard ratio (HR) for subsequent TRT was assessed for IVF and ICSI-treated men and compared to those who conceived spontaneously with age Cox regression analysis adjusted for age, educational level and previous intake of medicines for metabolic diseases.

Results
ICSI and IVF fathers had increased incidence of newly prescribed TRT compared to fathers conceiving spontaneously (ICSI: HR = 3.81, 95% CI = 3.09–4.69, P < 0.001; IVF: HR = 1.54, 95% CI = 1.15–2.05, P = 0.003). After adjustment for prescription of medication for one or more components of the MetS prior to TRT, the risk estimates attenuated but remained robust both for ICSI-treated (HR = 3.17 (95% CI: 2.56–3.9) and IVF-treated men (HR = 1.06 (95% CI: 1.05–1.07).

Conclusion
Men who have to utilise powerful techniques, such as ICSI for fathering children, may be at risk for testosterone deficiency. Routine endocrine evaluation of men seeking fertility treatment is hence warranted. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Infertility, Male, Testosterone/deficiency
in
European Journal of Endocrinology
publisher
Society of the European Journal of Endocrinology
external identifiers
  • scopus:85081912386
  • pmid:32061160
  • pmid:32061160
ISSN
1479-683X
DOI
10.1530/EJE-19-0734
language
English
LU publication?
yes
additional info
A Elenkov and Y Al-Jebari contributed equally to this work
id
a72a2a97-ca39-4706-9726-8966bfb78cc6
date added to LUP
2020-12-22 17:32:42
date last changed
2022-05-12 08:49:49
@article{a72a2a97-ca39-4706-9726-8966bfb78cc6,
  abstract     = {{Objectives<br>
Male hypogonadism is associated with higher risk of co-morbidity and premature mortality. It is, therefore, of utmost importance to identify young men who are at the highest risk of testosterone deficiency and who may benefit from preventive measures. In this context, infertile men constitute a high-risk group. The extent of testosterone replacement therapy (TRT) among infertile men, defined as men who have to undergo assisted reproduction for fatherhood, is currently unknown. Therefore, we evaluated the pattern of prescription of TRT in the years following child conception among men who have fathered children with the help of intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF).<br>
<br>
Design<br>
By sourcing data from national population registries, hazard ratio (HR) for subsequent TRT was assessed for IVF and ICSI-treated men and compared to those who conceived spontaneously with age Cox regression analysis adjusted for age, educational level and previous intake of medicines for metabolic diseases.<br>
<br>
Results<br>
ICSI and IVF fathers had increased incidence of newly prescribed TRT compared to fathers conceiving spontaneously (ICSI: HR = 3.81, 95% CI = 3.09–4.69, P &lt; 0.001; IVF: HR = 1.54, 95% CI = 1.15–2.05, P = 0.003). After adjustment for prescription of medication for one or more components of the MetS prior to TRT, the risk estimates attenuated but remained robust both for ICSI-treated (HR = 3.17 (95% CI: 2.56–3.9) and IVF-treated men (HR = 1.06 (95% CI: 1.05–1.07).<br>
<br>
Conclusion<br>
Men who have to utilise powerful techniques, such as ICSI for fathering children, may be at risk for testosterone deficiency. Routine endocrine evaluation of men seeking fertility treatment is hence warranted.}},
  author       = {{Elenkov, Angel and Al-Jebari, Yahia and Lundberg Giwercman, Yvonne and Giwercman, Aleksander}},
  issn         = {{1479-683X}},
  keywords     = {{Infertility, Male; Testosterone/deficiency}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Society of the European Journal of Endocrinology}},
  series       = {{European Journal of Endocrinology}},
  title        = {{Testosterone replacement therapy in men who conceived with intracytoplasmic sperm injection: nationwide register study}},
  url          = {{http://dx.doi.org/10.1530/EJE-19-0734}},
  doi          = {{10.1530/EJE-19-0734}},
  year         = {{2020}},
}