Spontaneous abortion in IVF couples--a role of male welding exposure.
BACKGROUND
Fume from welding of stainless steel contains hexavalent chromium, which in animal studies can induce paternally mediated spontaneous abortion. Human studies have shown conflicting results. The best studies include early pregnancy experience, but these are expensive to conduct. In vitro fertilization (IVF) provides new design opportunities. Our aim was to study pregnancy survival in IVF treated women with respect to paternal welding exposure.


METHODS
We mailed a questionnaire to 5879 couples from the Danish IVF register that covers all IVF treatments after 1993 (response ratio 68.2%). A subgroup of male metal workers received a second questionnaire on exposure to welding (n = 319 men, response ratio 77%). Information on outcome was collected from national health registers. Survival of the first hCG-positive pregnancy was analysed using Cox regression.


RESULTS
The proportion of pregnancies terminated by spontaneous abortion before 28 gestational weeks was 18% (n = 91 pregnancies) and 25% (n = 128) in pregnancies with paternal exposure to stainless steel welding and mild steel welding, respectively. In the reference group of 2925 pregnancies the abortion ratio was 28%. The risk ratio for pregnancies with paternal exposure to stainless steel was 0.6 (95% CI 0.4-1.0).


CONCLUSIONS
We found no increased risk of spontaneous abortion in IVF treated women, who became pregnant by a man exposed to welding of any sort. Since the process of fertilization and selection of IVF pregnancies differs from natural pregnancies the negative results need not apply to other pregnancies.
Hjollund
N H
NH
Department of Occupational Medicine, Aarhus University Hospital, DK-8000, Aarhus, Denmark. nhh@ag.aaa.dk
Bonde
J P
JP
Ernst
E
E
Lindenberg
S
S
Andersen
A N
AN
Olsen
J
J
D000022:Abortion, Spontaneous / Q000209:etiology*; D000328:Adult; D000818:Animals; D002857:Chromium / Q000009:adverse effects; D003718:Denmark; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D016273:Occupational Exposure; D018812:Paternal Exposure; D011247:Pregnancy; D012042:Registries; D012307:Risk Factors; D013193:Stainless Steel / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014896:Welding
D002857:Chromium; D013193:Stainless Steel; C074702:chromium hexavalent ion