Oral Virtual Presentation (Virtual only) ESA-SRB-ANZBMS 2021

Reproductive and metabolic health of young men conceived using ICSI (#142)

Sarah Catford 1 2 3 , Jane Halliday 3 4 , Sharon Lewis 3 4 , Moira O'Bryan 5 , David Handelsman 6 , Roger Hart 7 8 , John McBain 9 10 11 , Luk Rombauts 2 12 , David Amor 3 4 , Richard Saffery 3 4 , Robert McLachlan 1 2 12
  1. Hudson Institute of Medical Research, Melbourne
  2. Department of Obstetrics and Gynaecology, Monash University, Melbourne
  3. Murdoch Children's Research Institute, Melbourne
  4. Department of Paediatrics, University of Melbourne, Melbourne
  5. The School of BioSciences, Faculty of Science, University of Melbourne, Melbourne
  6. ANZAC Research Institute, University of Sydney and Department of Andrology, Concord Hospital, Sydney
  7. Division of Obstetrics and Gynaecology, University of Western Australia, Perth
  8. Fertility Specialists of Western Australia, Perth
  9. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne
  10. Melbourne IVF, Melbourne
  11. Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne
  12. Monash IVF Group, Melbourne

Background:

Since its introduction for male infertility, the use of intracytoplasmic sperm injection (ICSI) has increased. Concerns include the heritability of infertility, effects of poor-quality spermatozoa on offspring health and epigenetic effects of the ICSI procedure. The long-term health of ICSI-conceived offspring is unclear.

 

Aim:

Compare reproductive and metabolic health of ICSI-conceived men (aged 18-25 years) to IVF-conceived and spontaneously-conceived (SC) controls.

 

Method:

This study is part of a project investigating health outcomes and epigenetic profiles of ICSI-conceived men. Age-matched controls were sourced from prior studies. Semen parameters and serum reproductive hormones were compared between 120 ICSI-conceived men and 356 SC controls. Resting blood pressure (BP), BMI, body surface area, and serum metabolic markers were compared between 121 ICSI-conceived, 74 IVF-conceived and 688 SC men.

 

Results:

Compared with SC controls, ICSI-conceived men had similar sperm output and total motile sperm count but lower mean total (55.3 vs 60.6%, p=0.003) and progressive (44.7 vs 53.9%, p<0.001) sperm motility with higher mean normal sperm morphology (8.5 vs 5.4%, p<0.001). Differences in progressive motility (ß -9.9, 95% CI -16.7- -3.0, p=0.01) and normal morphology (ß 4.3, 95% CI 3.0-5.7, p<0.001) remained significant after adjusting for confounders. ICSI-conceived men were no more likely to have below reference semen parameters. Semen parameters between ICSI fathers and sons were not correlated. Serum reproductive hormones were better in ICSI-conceived men.

ICSI-conceived men compared with SC controls had higher resting diastolic BP and higher homeostasis model assessment for insulin resistance (HOMA-IR), but a similar proportion had insulin resistance. Metabolic parameters of ICSI-conceived men and IVF-conceived controls were similar.

 

Conclusion:

This study is the largest to date and suggests comparable reproductive health of ICSI-conceived men to a population-representative cohort of SC men. Few metabolic differences of unclear significance were observed between ICSI-conceived men, and IVF-conceived and SC controls.