Exploring the association of male-factor related infertility with first-trimester anomalies, aneuploidy, and biochemical markers in infertile patients undergoing ART

Abstract

Background: A higher risk of birth defects in assisted reproductive technologies (ART) pregnancies compared to natural pregnancies has been previously reported. Objective: This retrospective study aimed to explore the association of male-factor related infertility with first-trimester anomalies, aneuploidy, and biochemical markers in infertile patients undergoing ART. Method: The complete medical records of infertile patients referred to the infertility and prenatal centers in Ahvaz, Iran during the past five years were assessed, which included ART-induced pregnancies due to male factors (n=124) and or other infertility causes (n=176). Results: The most common causes of infertility were respectively the male factor (41.3%), ovulation disorders (26%), and unexplained factors (13.3%). A significant correlation was found between the infertility causes and the history underlying systemic diseases and medication history (p<0.05). The serum levels of MoM β‐hCG and PAPP-A were significantly lower in the male factor-related infertilities than non-male factor-related infertilities (p=0.0001). The rate of fetal and placental anomalies was significantly higher in male factor-related infertilities than non-male factor-related infertilities (p=0.03). However, according to the results of multivariable logistic regression, association between the male factor-related infertility and fetal/placental anomalies was not independent of the effects of low levels of MoM β‐hCG and PAPP-A. Conclusion: Causes of infertility, particularly male factor, together with low levels of MoM β‐hCG and PAPP-A, might be associated with the high risk of fetal and placental anomalies in ART pregnancies. However, further large-scale multi-center and prospective investigations are needed to reach more accurate conclusion.