Hormone Therapy

Testosterone deficiency and metabolic disturbances in men who fathered a child by use of donated spermatozoa.

TL;DR

Fathers to children conceived by use of donated spermatozoa are at significantly increased risk for testosterone treatment and dyslipidaemia, necessitating stringent follow up and inclusion in prevention programs.

Key Findings

Men who fathered children using donated spermatozoa had a markedly higher risk of being prescribed testosterone replacement therapy compared to men who fathered children with their own gametes.

  • HR: 18.14; 95% CI: 11.71–28.10; p ≪ 0.001
  • Analysis based on 410,119 childbirths, of which 390 utilized donated spermatozoa
  • Cox regression models were adjusted for age, educational level, and previous cancer treatment
  • Follow-up started at time of conception

Men who fathered children using donated spermatozoa had a significantly higher risk of being prescribed medication for dyslipidaemia compared to natural-conception fathers.

  • HR: 2.08; 95% CI: 1.27–3.39; p = 0.003
  • This finding persisted after adjustment for age, educational level, and previous cancer treatment
  • The association was specific to dyslipidaemia and was not observed for diabetes

No statistically significant increased risk of diabetes (type 1 or type 2) medication prescription was found in fathers using donated spermatozoa.

  • The abstract explicitly states 'but not diabetes' when describing elevated risks
  • Both type 1 and type 2 diabetes were assessed as outcomes in the Cox regression analysis

Swedish nationwide register data covering all fathers with live-born children between 2007 and 2014 were used to identify 410,119 childbirths, including 390 involving donated spermatozoa.

  • Data source was Swedish nationwide registers
  • The comparison group consisted of fathers who became fathers using their own gametes
  • Outcomes measured were post-conception prescriptions for hypertension, diabetes, dyslipidaemia, and testosterone replacement therapy
  • Men using donated spermatozoa were presumed to have non-obstructive azoospermia representing severe impairment of fertility

A dose-response association between the level of semen quality impairment and risk of morbidity or premature death has been previously reported, providing the rationale for studying men with the most severe impairment.

  • Men utilizing donated spermatozoa, i.e. patients with non-obstructive azoospermia, are presumed to be at the highest risk for adverse health outcomes
  • This background association motivated the study of this specific population as a high-risk group

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Citation

Elenkov A, Zarén P, Sundell B, Lundin L, Giwercman A. (2022). Testosterone deficiency and metabolic disturbances in men who fathered a child by use of donated spermatozoa.. Scientific reports. https://doi.org/10.1038/s41598-022-17864-y