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Testosterone replacement therapy in men who conceived with intracytoplasmic sperm injection: nationwide register study.
Eur J Endocrinol. 2020 Apr; 182(4):423-428.EJ

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 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.

Authors+Show Affiliations

Lund University, Molecular Genetic Reproductive Medicine, Malmö, Sweden. Skåne University Hospital Malmö, Reproductive Medicine Center, Malmö, Sweden.Lund University, Molecular Genetic Reproductive Medicine, Malmö, Sweden.Lund University, Molecular Genetic Reproductive Medicine, Malmö, Sweden.Lund University, Molecular Genetic Reproductive Medicine, Malmö, Sweden. Skåne University Hospital Malmö, Reproductive Medicine Center, Malmö, Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32061160

Citation

Elenkov, Angel, et al. "Testosterone Replacement Therapy in Men Who Conceived With Intracytoplasmic Sperm Injection: Nationwide Register Study." European Journal of Endocrinology, vol. 182, no. 4, 2020, pp. 423-428.
Elenkov A, Al-Jebari Y, Giwercman YL, et al. Testosterone replacement therapy in men who conceived with intracytoplasmic sperm injection: nationwide register study. Eur J Endocrinol. 2020;182(4):423-428.
Elenkov, A., Al-Jebari, Y., Giwercman, Y. L., & Giwercman, A. (2020). Testosterone replacement therapy in men who conceived with intracytoplasmic sperm injection: nationwide register study. European Journal of Endocrinology, 182(4), 423-428. https://doi.org/10.1530/EJE-19-0734
Elenkov A, et al. Testosterone Replacement Therapy in Men Who Conceived With Intracytoplasmic Sperm Injection: Nationwide Register Study. Eur J Endocrinol. 2020;182(4):423-428. PubMed PMID: 32061160.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Testosterone replacement therapy in men who conceived with intracytoplasmic sperm injection: nationwide register study. AU - Elenkov,Angel, AU - Al-Jebari,Yahia, AU - Giwercman,Yvonne Lundberg, AU - Giwercman,Aleksander, PY - 2019/09/16/received PY - 2020/02/11/accepted PY - 2020/2/16/pubmed PY - 2020/3/24/medline PY - 2020/2/16/entrez SP - 423 EP - 428 JF - European journal of endocrinology JO - Eur. J. Endocrinol. VL - 182 IS - 4 N2 - 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. SN - 1479-683X UR - https://www.unboundmedicine.com/medline/citation/32061160/Testosterone_Replacement_Therapy_in_Men_who_Conceived_with_Intracytoplasmic_Sperm_Injection_-_Nationwide_Register_Study L2 - https://eje.bioscientifica.com/doi/10.1530/EJE-19-0734 DB - PRIME DP - Unbound Medicine ER -