More Prevalent Prescription of Medicine for Hypertension and Metabolic Syndrome in Males from Couples Undergoing Intracytoplasmic Sperm Injection

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Male infertility / sub-fertility (couples undergoing ICSI or IVF) (n=459766). Intervention: Conception via Intracytoplasmic Sperm Injection (ICSI) vs. Conception without assisted reproduction techniques (non-IVF/ICSI control group). Primary outcome: Filled drug prescription for hypertension (HT) (HR 1.15, 95% CI 1.06-1.24, p=0.001).

Q: What does this research mean for the field?

Fathers who conceive via intracytoplasmic sperm injection (ICSI) have a significantly higher risk of being prescribed medications for hypertension and metabolic syndrome compared to fathers conceiving without assisted reproductive technology. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Angel Elenkov; Yahia Al-Jebari; Aleksander Giwercman

doi:10.1038/s41598-018-32813-4

September 24, 2018Scientific ReportsOpen Access

More Prevalent Prescription of Medicine for Hypertension and Metabolic Syndrome in Males from Couples Undergoing Intracytoplasmic Sperm Injection

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Key result

Fathers who conceived via ICSI had a significantly higher risk of being prescribed antihypertensive medication (HR 1.15, 95% CI 1.06-1.24, p=0.001) and metabolic syndrome medications (HR 1.28) compared to non-IVF/ICSI fathers.

Why the study?

Men with impaired fertility are at higher risk for adult-onset diseases than fertile men, and sub-fertile men undergoing ICSI are well suited as targets for preventive measures given their contact with the health care system.

Do men from couples undergoing intracytoplasmic sperm injection (ICSI) have a higher risk of being prescribed medications for hypertension and metabolic syndrome compared to men conceiving without assisted reproduction?

Study Design

Type

Cohort (n=459,766)

Multicenter

Yes

Structured PICO

Do men from couples undergoing intracytoplasmic sperm injection (ICSI) have a higher risk of being prescribed medications for hypertension and metabolic syndrome compared to men conceiving without assisted reproduction?

P

Population

459,766 men (mean age at first conception 31.1-35.9 years, 0% female) who fathered their first-born child in Sweden between 2006 and 2016, followed from the father's birth via national health and prescription registries.

E

Exposure

Conception via Intracytoplasmic Sperm Injection (ICSI, n=8,514; 1.9%) or standard In Vitro Fertilization (IVF, n=10,748; 2.3%) as a proxy for male sub-fertility.

C

Comparator

Fathers who conceived their first child without assisted reproduction techniques (non-IVF/ICSI control group, n=440,504; 95.8%).

O

Outcome

Filled prescriptions for medications treating hypertension (HT), diabetes mellitus (DM), dyslipidemia (DLE), and metabolic syndrome (MetS, defined by ATPIII proxy as having filled prescriptions for all three: DM, HT, and DLE) recorded in the Swedish Prescribed Drug Register (from July 1, 2005 onwards), with follow-up starting from the father's birth.surrogate

Main Result

Hazard Ratio: 1.15 (95% CI 1.06–1.24)

Absolute Event Rate: 8.7% vs 4.7%

p-value: p=0.001

Limitations

ICSI group may include men with normal or slightly subnormal fertility (e.g., cancer patients using frozen sperm or couples with failed standard IVF).
Sub-fertile men or cases treated with sperm donation and intrauterine insemination may be misclassified into the non-IVF/ICSI control group.
Men with the most severe infertility who failed to become biological fathers were excluded, introducing selection bias.
Registry data only capture filled prescriptions, missing metabolic syndrome components managed solely by lifestyle modifications.
Registry data cannot establish causality or account for specific infertility diagnoses, female partner factors, or socioeconomic variables beyond education.
ICSI group may include men with normal fertility (e.g., frozen sperm prior to cancer therapy or failed prior standard IVF).
Control group may include sub-fertile men or couples who used donor sperm/intrauterine insemination.
Exclusion of severely infertile men who never succeeded in fathering a live birth introduces selection bias.
Reliance on drug prescription registries underestimates prevalence by missing untreated disease or conditions managed with lifestyle changes alone.
Lack of data on specific infertility etiology, female partner factors, and socioeconomic confounders beyond educational level.

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Answers are grounded in this paper and cite their sources.

Implication

Men fathering children via ICSI have an elevated risk of requiring pharmacological treatment for hypertension and metabolic syndrome, identifying sub-fertile men as a key target population for early cardiovascular and metabolic preventive screening.

Abstract

Register-based studies have indicated that men with impaired fertility are at higher risk for developing various adult-onset diseases than fertile men. The majority of men undergoing ICSI treatment are sub-fertile and since they are in contact with the health care system, these men are well suited as target for preventive measures. Our study included all men (N = 459 766) who had fathered children in Sweden between 2006 and 2016. Swedish registry data was used for obtaining information regarding conception method and defining three groups of fathers - ICSI -treated, IVF - treated and non IVF/ICSI. By sourcing data from the Swedish Prescribed Drug Register, we specifically searched for information regarding prescription and usage of at least one prescription for diabetes mellitus, hypertension (HT) or dyslipidemia to serve as a proxy for metabolic disease among the study groups. If all three types of medicine were prescribed, the patient was considered as having metabolic syndrome. Our results indicate male partners in couples who became parents using ICSI to be at higher risk for being treated for hypertension (HR = 1.15 95% CI: 1.06-1.24, p = 0.001) and metabolic syndrome (HR = 1.28 95% CI: 1.01-1.58, p = 0.042) when compared to non IVF/ICSI men.

Discussion

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Cite This Study

Elenkov et al. (2018) conducted a cohort in Male infertility / sub-fertility (couples undergoing ICSI or IVF) (n=459,766). Conception via Intracytoplasmic Sperm Injection (ICSI) vs. Conception without assisted reproduction techniques (non-IVF/ICSI control group) was evaluated on Filled drug prescription for hypertension (HT) (HR 1.15, 95% CI 1.06-1.24, p=0.001). Fathers who conceived via ICSI had a significantly higher risk of being prescribed antihypertensive medication (HR 1.15, 95% CI 1.06-1.24, p=0.001) and metabolic syndrome medications (HR 1.28) compared to non-IVF/ICSI fathers.

synapsesocial.com/papers/6ac6f1eb28ac3928b6ec4545 https://doi.org/10.1038/s41598-018-32813-4

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More Prevalent Prescription of Medicine for Hypertension and Metabolic Syndrome in Males from Couples Undergoing Intracytoplasmic Sperm Injection

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

More Prevalent Prescription of Medicine for Hypertension and Metabolic Syndrome in Males from Couples Undergoing Intracytoplasmic Sperm Injection

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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