Hypospadias after assisted reproduction incorporating in vitro fertilization and gamete intrafallopian transfer.

OBJECTIVE

To determine incidence of hypospadias in infants born as a result of assisted reproductive technology (ART).

DESIGN

Prospective data collection.

SETTING

Parents with various forms of infertility attended an in-hospital in vitro fertilization program.

PATIENTS: Two of the 53 male infants, conceived as a result of ART over a 3-year period, were born with hypospadias.

INTERVENTIONS: Patient no. 1 underwent follicular stimulation (17 ampules of human menopausal gonadotropin (hMG), followed by 10,000 IU of human chorionic gonadotropin (hCG) 60 hours after the last hMG). Patient no. 2 underwent follicular stimulation with clomiphene citrate 100 mg/d from days 3 to 7, followed by 14 ampules of hMG starting day 6, and 10,000 IU of hCG 30 hours after her last hMG.

MAIN OUTCOME MEASURES: All infants were examined in the immediate postpartum period for congenital anomalies.

RESULTS

Infant no. 1, one of a set of dizygotic twins, had penoscrotal hypospadias, with normal renal sonogram and chromosomal studies. Infant no. 2 had glandular hypospadias with the urinary meatus displaced to the border of the glans.

CONCLUSION

This high incidence raises concern about possible links between assisted reproduction and hypospadias.