Reproductive function in men conceived with in vitro fertilization and intracytoplasmic sperm injection

Objective: To determine the semen quality and reproductive hormones of men conceived by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) compared with men conceived without assisted reproductive technology (ART). Design: Cohort study. Setting: IVF centers in Victoria and the Western Australian Raine Study. Patient(s): Men conceived with IVF/ICSI and men conceived without ART aged 18–25 years. Intervention(s): Clinical review. Main Outcome Measure(s): The primary outcome was the prevalence of severe oligozoospermia (sperm concentration, <5 million/mL). The secondary outcomes were total sperm count, total and progressive motility, total motile count, normal morphology, and serum testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Results: There was no difference in the prevalence of severe oligozoospermia between 120 men conceived with IVF/ICSI and 356 men conceived without ART (9% vs. 5.3%). Men conceived with IVF/ICSI had similar sperm concentration, total sperm count, and total motile count but lower mean total (55.3% vs. 60.6%) and progressive (44.7% vs. 53.9%) sperm motility with higher mean normal morphology (8.5% vs. 5.4%). Differences in progressive motility (ß, -9.9; 95% confidence interval [CI], -16.7 − -3.0), normal morphology (ß, 4.3; 95% CI, 3.0–5.7), and proportion with abnormal morphology (adjusted odds ratios, 0.1; 95% CI, 0.04–0.5) remained significant after adjusting for confounders. Men conceived with IVF/ICSI had lower mean FSH (3.3 IU/L) and LH (3.9 IU/L) levels and higher mean testosterone levels (19.1 nmol/L) than controls (4.2 IU/L, 11.0 IU/L, and 16.8 nmol/L). Conclusion: This study of men conceived with IVF/ICSI found similar sperm output to men conceived without ART. Overall, the results are reassuring.