In vitro fertilization is associated with an increased risk of hypospadias

Purpose: The purpose of this study was to determine if there is an increase d incidence of hypospadias in male offspring conceived by in vitro fertiliz ation (IVF). Materials and Methods: A retrospective institutional chart review from 1988 to 1992 and data from the Maryland Birth Defects Registry were statistical ly analyzed to assess the risk of hypospadias with IVF. Results: The data for the 5-year period indicated a 5-fold increased risk o f hypospadias after IVF, with an incidence of approximately 1.5% in the IVF group and 0.3% in the control group. The only recognized difference betwee n the groups was maternal progesterone administration in the NF group but t he cause of the increased risk of hypospadias was unknown. The distribution of hypospadias severity was similar in both groups. Conclusions: Male newborns conceived by IVF have a 5-fold increased risk of hypospadias, which may be related to maternal progesterone administration, or other maternal or fetal endocrine abnormalities that may or may not he related to infertility. Health care providers should be aware of this risk so that they can properly counsel infertile couples seeking assisted reprod uction by IVF technology.