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Little is known the about the reproductive health of offspring after fertility treatment. In 2001-2005, the authors approached young Danish men attending a compulsory physical examination to determine their fitness for military service. A total of 1,925 men volunteered, delivered a semen sample, had a physical examination performed and a blood sample drawn, and responded to a questionnaire. Their mothers were questioned about whether they had received fertility treatment in order to conceive their sons. Forty-seven mothers reported having received fertility treatment to conceive the index subject. After control for confounders, men whose mothers had received fertility treatment to conceive them had a 46% lower sperm concentration (95% confidence interval (CI): -63, -20) and a 45% lower total sperm count (95% CI: -64, -16). They had a smaller testis size (-0.9 ml, 95% CI: -2.2, 0.4), fewer motile sperm (-4.0%, 95% CI: -8.0, -0.1), and fewer morphologically normal spermatozoa (-2.0%, 95% CI: -4.1, 0.0). They also had a lower serum testosterone level and free androgen index (results not statistically significant). These findings should be viewed in light of the increasing use of fertility treatments. Although the cause of these findings is unknown, they raise concern about possible late effects of fertility treatment. Larger-scale studies of children born after fertility treatment should be performed. [ABSTRACT FROM AUTHOR]

Purpose: The etiology of hypospadias is poorly understood. Exposure to pesticides has been considered a risk factor, although findings are inconsistent. Diet constitutes a significant exposure route for pesticides, and pesticide residues are more frequently reported in conventional than organic food products. We examined the association between organic dietary choice during pregnancy and presence of hypospadias in the offspring., Materials and Methods: Mothers of 306 boys operated on for hypospadias were frequency matched for geography and child birth year to 306 mothers of healthy boys in a case-control study. Telephone interviews were conducted regarding demographic and lifestyle factors, including intake and organic choice of selected food items (milk, dairy products, egg, fruit, vegetables and meat). Logistic regression models were constructed for dietary variables, and odds ratios were calculated controlling for maternal age, body mass index and alcohol consumption., Results: Overall organic choice of food items during pregnancy was not associated with hypospadias in the offspring. However, frequent current consumption of high fat dairy products (milk, butter) while rarely or never choosing the organic alternative to these products during pregnancy was associated with increased odds of hypospadias (adjusted OR 2.18, 95% CI 1.09-4.36)., Conclusions: This large case-control study of boys operated on for hypospadias suggests an association between hypospadias in the offspring and the mother not choosing the organic alternative, and having a high current intake of nonorganic butter and cheese. This finding could be due to chemical contamination of high fat dairy products. However, general lifestyle and health behavior related to choosing organic alternatives may also explain the finding., (Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Popliteal pterygium syndrome (PPS) and Van der Woude syndrome (VWS) are caused by mutations in the gene interferon regulatory factor 6 (IRF6). Skeletal, genital malformations and involvement of the skin occur in PPS and orofacial clefting and lip pits occur in both. We report on a patient with unilateral cleft lip and palate, ankyloblepharon, paramedian lip pits, unilateral renal aplasia, and a coronal hypospadias. By sequencing IRF6, we detected a novel missense mutation (Arg339Ile). The other family members were unaffected and had no IRF6 mutations, including the patient's brother who was also born with hypospadias. The patient and his brother were both conceived by in vitro fertilization (IVF). It is discussed whether the renal malformation in the patient is related to the IVF procedure or to the IRF6 mutation., (2008 Wiley-Liss, Inc.)

Objective: To study the relationship between self-rated health (SRH) and semen quality., Design: Cross-sectional study of men attending a compulsory physical examination to determine their fitness for military service from 1996 to 2005., Setting: Young men were approached when they were summoned for a compulsory physical examination to determine their fitness for military service in two major Danish cities., Patient(s): A total of 3,457 Danish young men delivered a semen sample, had a physical examination performed, and responded to a questionnaire including a question about SRH., Intervention(s): None., Main Outcome Measure(s): Semen quality and testis size., Result(s): After control for confounders, men with good and poor SRH had, respectively, 0.5 mL (95% CI: -0.8, -0.1) and 0.8 mL (95% CI: -2.4, 0.8) smaller testes size compared to men with very good SRH, the trend was statistically significant. Men with good and poor SRH had, respectively, 12.2% (95% CI: -21.2%, -2.2%) and 26.9% (95% CI: -55.7%, 20.8%) lower total sperm count compared to men with very good SRH, the trend was statistically significant, and had +0.4% (-1.4%, 2.2%) and 1.4% (-3.5%, 0.7%) fewer morphologically normal sperms (trend statistically significant). Percentages of motile spermatozoa and semen volume were not significantly associated with SRH., Conclusion(s): We found significant associations between SRH and semen quality and testicular size. Given the cross-sectional study design, we cannot establish a causal relationship but argue that SRH may be associated with semen quality. Our findings need to be validated and confirmed with other study designs (preferably prospective) and in populations of different age structure and fertility status.

Background: Recent studies found an association between a long waiting time to pregnancy (TTP) and reduced probability of twinning and a reduced dizygotic (DZ) twinning rate in subfertile men. However, it remains unsolved whether semen quality is associated with twin offspring. We therefore studied the semen quality in a group of fathers of naturally conceived twins., Methods: In this study, 37 fathers of DZ twins and 15 fathers of monozygotic (MZ) twins participated, and 349 normal fertile men served as a reference group. All men delivered a semen sample, underwent a physical examination and completed a questionnaire., Results: After adjustment, fathers of DZ and MZ twins had 3.6 (95% CI 1.7; 5.4) and 4.6 (95% CI 2.0; 7.2) percentage points higher percentage of sperm cells with normal morphologic features and percentages of motile sperm cells were 11.5 (95% CI 7.2; 15.9) and 12.5 (95% CI 6.3; 18.6) percentage points higher than the reference group (P < 0.01). Fathers of DZ twins and MZ twins had 24.7 (95% CI; -9.1; 71.3) and 17.0% (-25.2%; 83.0%) higher sperm concentration than the reference group., Conclusions: Fathers of DZ twins had a better semen quality than the reference group, which supports the assumption that spontaneous DZ twinning rate can be used as a sensor of male fecundity of a population.

Introduction: Retrospectively we evaluated the surgical treatment of all primary operations for hypospadias performed at the Department of Plastic- and Reconstructive Surgery, Herlev University Hospital, over a period of ten years. During this time we changed the concept of surgical procedure from various two-stage techniques to a new one-stage modification (Scuderi's vascularised vertical preputial island flap combined with a triangular flap glanuloplasty and other refinements). Secondly, we evaluated the pre- and postoperative examination., Materials and Methods: During the period 1993-2003, 96 patients were primarily operated. The new one-stage technique was used in 58 patients, all performed by the same surgeon. The standardised follow-up time was three months., Results: Complications consisted of five urethrocutaneous fistulas (8.6%) and four meatal stenosis (6.7%), and the functional and cosmetic short-term outcome was satisfactory using the new one-stage procedure. The number of operations per patient was reduced from 4.57 to 1.26. We found the pre- and postoperative examination inadequate concerning classification of hypospadias type and possible associated malformations (cryptorchidism)., Conclusion: The short-term functional and cosmetic outcome of the new one-stage technique was satisfactory. The complication rate was low. However, the study was associated with severe methodological problems. On this background we suggest a national standardised registration of all boys operated for hypospadias.

The testicular dysgenesis syndrome (TDS) hypothesis proposes that the four conditions cryptorchidism, hypospadias, impaired spermatogenesis and testis cancer may all be manifestations of disturbed prenatal testicular development. The TDS hypothesis is based on epidemiological, clinical and molecular studies, all suggestive of an interrelation between the different symptoms. The aetiology of TDS is suspected to be related to genetic and/or environmental factors, including endocrine disrupters. Few human studies have found associations/correlations between endocrine disrupters, including phthalates, and the different TDS components. However, for ethical reasons, evidence of a causal relationship between prenatal exposure and TDS is inherently difficult to establish in human studies, rendering the recently developed animal TDS model an important tool for investigating the pathogenesis of TDS. Clinically, the most common manifestation of TDS is probably a reduced sperm concentration, whereas the more severe form may include a high risk of testis cancer. Clinicians should be aware of the interconnection between the different features of TDS, and inclusion of a programme for early detection of testis cancer in the management of infertile men with poor semen quality is recommended.

For many years it has been acknowledged that Danish and Norwegian men have one of the highest risks in the world for testicular cancer in sharp contrast to neighbouring Baltic men from Finland, Estonia and Lithuania. As an association between poor semen quality and testicular cancer has been established, it was suggested that men from high-risk testicular cancer areas would be more likely to have poor semen quality. However, previous studies were not able to elucidate this question due to their retrospective nature. In prospectively designed and strictly controlled studies of fertile men, the existence of regional differences in semen quality was confirmed. In addition, studies of men from the general populations were undertaken and a similar regional difference in semen quality was detected. Men from the eastern part of the Nordic-Baltic area had better semen quality than men from the western part. These findings parallel the incidence of testicular cancer in these regions. Approximately 20% of young men from Norway and Denmark had sperm concentrations below the World Health Organization reference level of 20 x 10(6) spermatozoa/mL, and approximately 40% had <40 x 10(6) spermatozoa/mL which, according to recent publications, may be the 'threshold' below which fecundity declines. In Denmark, the situation is of concern and a continued surveillance of semen quality in young men was established in 2001 by a government-supported programme.