title: In vitro fertilization is associated with an increased risk of hypospadias.
abstract: OBJECTIVE
  The purpose of this study was to determine if there is an increased incidence of hypospadias in male offspring conceived by in vitro fertilization (IVF).
  
  
  METHODS
  A retrospective institutional chart review from 1988 to 1992 and data from the Maryland Birth Defects Registry were statistically analyzed to assess the risk of hypospadias with IVF.
  
  
  RESULTS
  The data for the 5-year period indicated a 5-fold increased risk of 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 between the groups was maternal progesterone administration in the IVF group but the 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 be related to infertility. Health care providers should be aware of this risk so that they can properly counsel infertile couples seeking assisted reproduction by IVF technology.
authors.affiliation: Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: R I
authors.initials: RI
authors.lastname: Silver
authors.forename: R
authors.initials: R
authors.lastname: Rodriguez
authors.forename: T S
authors.initials: TS
authors.lastname: Chang
authors.forename: J P
authors.initials: JP
authors.lastname: Gearhart
mesh_terms: D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D007021:Hypospadias / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012189:Retrospective Studies; D012307:Risk Factors