Abstract
BackgroundMale gonadal exposure to ionizing radiation may disrupt spermatogenesis, but its influence on the fecundity of couples has been rarely studied. We aimed to characterize the influence of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy.MethodsWe recruited a random sample of women who retrospectively described 1110 periods of unprotected intercourse beginning between 1985 and 1999 and leading either to a live birth or to no pregnancy; their duration was censored after 13 months. The male partner answered a telephone questionnaire on radiodiagnostic examinations. We assigned a mean gonadal dose to each type of radiodiagnostic examination. We defined male dose for each period of unprotected intercourse as the sum of the gonadal doses of the X-ray examinations experienced between 18 years of age and the date of discontinuation of contraception. Time to pregnancy was analysed using a discrete Cox model with random effect allowing to estimate hazard ratios of pregnancy.ResultsAfter adjustment for female factors likely to influence fecundity, there was no evidence of an association between male dose and the probability of pregnancy (test of homogeneity, p = 0.55). When compared to couples with a male gonadal dose between 0.01 and 0.20 milligrays (n = 321 periods of unprotected intercourse), couples with a gonadal dose above 10 milligrays had a hazard ratio of pregnancy of 1.44 (95% confidence interval, 0.73–2.86, n = 31).ConclusionOur study provides no evidence of a long-term detrimental effect of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy during the year following discontinuation of contraceptive use. Classification errors due to the retrospective assessment of male gonadal exposure may have limited the statistical power of our study.
Highlights
Male gonadal exposure to ionizing radiation may disrupt spermatogenesis, but its influence on the fecundity of couples has been rarely studied
After restriction to the observations with defined Time To Pregnancy (TTP) and male gonadal dose, we included 704 women and their current partners, describing a total of 1110 periods of unprotected intercourse (Figure 1); these corresponded to 1068 live births, 13 pregnancies current for three months or more at the time of the interview, and 29 periods of involuntary infertility of one year or more, of which 11 occurred among couples who had a live birth during the study period
Probability of pregnancy and male gonadal dose of ionizing radiation The proportion of conceptions in the first month after discontinuation of birth control methods thereafter leading to a live birth was 23.5%; 86.8% of the couples conceived within 12 months of unprotected intercourse
Summary
Male gonadal exposure to ionizing radiation may disrupt spermatogenesis, but its influence on the fecundity of couples has been rarely studied. We aimed to characterize the influence of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy. A few studies [9,10,11] have examined the effect of male exposure to ionizing radiation on the probability of pregnancy or on the occurrence of involuntary infertility. The power of this study may have been reduced by the fact that only about half of the couples experiencing 12-month involuntary infertility decide to consult a medical doctor [12]. No direct estimate of gonadal dose was given and fertility was reduced for survivors who received no treatment at all
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