Maternal endometriosis and genital malformations in boys: a Danish register-based study

In this large cohort study of more than 1 million motherson pairs, we found no strong associations between maternal endometriosis and genital anomalies in sons.

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Volume 108, Issue 4, Pages 687–693

Authors:

Linn Håkonsen Arendt, M.D., Morten Søndergaard Lindhard, M.D., Ph.D., Tine Brink Henriksen, M.D., Ph.D., Axel Forman, M.D., Ph.D., Jørn Olsen, M.D., Ph.D., Cecilia Høst Ramlau-Hansen, M.Sc.P.H., Ph.D.

Abstract:

Objective

To investigate the association between maternal endometriosis and occurrence of the genital anomalies cryptorchidism and hypospadias in sons.

Design

Population-based cohort study.

Setting

Not applicable.

Patient(s)

All live-born singleton boys born from 1978 to 2012.

Intervention(s)

None.

Main Outcome Measure(s)

Cryptorchidism and hypospadias in boys based on information from the Danish National Patient Register.

Result(s)

The study included 1,073,026 live-born singleton boys. A total of 6,443 boys were sons of women diagnosed with endometriosis before pregnancy. Altogether, 27,342 boys were diagnosed with cryptorchidism, of whom 16,446 had corrective surgery. Hypospadias was diagnosed in 4,853 boys. As compared with unexposed boys, a tendency towards a slightly higher occurrence of cryptorchidism was observed among boys of women with endometriosis (adjusted hazard ratio [aHR] 1.18; 95% confidence interval [CI], 0.97, 1.44). When stratified by medically assisted reproduction (MAR) technologies, the association was slightly stronger among boys born to women with endometriosis who had conceived via MAR, yet it remained moderate and statistically insignificant (aHR 1.27; 95% CI, 0.97, 1.70). When women who conceived with MAR were excluded, the association between endometriosis and cryptorchidism disappeared. For hypospadias, we observed no association, either in the main analysis or the stratified analysis.

Conclusion(s)

The findings from this register-based study do not provide strong evidence for a higher occurrence of the studied genital anomalies among boys of women with endometriosis.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

1 Comments

Go to the profile of Sylvie Mesrine
Sylvie Mesrine almost 3 years ago

Dear Dr Arendt

I read avec interest your article. However, results in the abstract and in the text and Table 4 are discordant:

- in text: boys born to women with endometriosis who had conceived via MAR  (aHR 1.27; 95% CI, 0.97, 1.70) as  compared with unexposed boys,

and in table 4: aHR 1.27; 95% CI, 0.86, 1.88.

Could you tell me, please, if there are mistakes in the table 4 or in the text?

Best regards,

Dr Sylvie Mesrine
Gynecologist, MD

Tours, France