(124) SUBFERTILITY RISK IN MALE SIBLINGS OF PEDIATRIC BILATERAL INGUINAL SURGERY PATIENTS

Abstract Introduction Cryptorchidism, a condition linked to male infertility, often presents with bilateral undescended testicles in about 10% of cases. While surgery aims to preserve fertility, genetic predispositions to sub-fertility among brothers of those who had pediatric bilateral inguinal surgery remain under explored. Objective In this study, we compared fertility outcomes between males who had bilateral inguinal surgery for hernias or undescended testes and their brothers, hypothesizing a higher sub-fertility risk among brothers of pediatric bilateral orchiopexy patients. Methods A statewide database that combines demographic, medical, and residential data for over 90% of the state's pediatric population was used. Our cohort were patients who underwent B/L IHR or BO prior to age 18, and their brothers born within 10 years of the B/L IHR or BO cases. A logistic regression model with clustering on family was performed to assess the likelihood for male siblings to develop male factor infertility controlling for time in Utah since 1996, infertility in the spouse, or unidentified partner data. A mixed-effect Poisson regression with the same parameters was used to assess the number of children in each group. Results 1019 B/L IHR siblings (627 cases), 360 BO siblings (221 cases), were identified from 1996-2022. The BO sibling cohort was majority white (93.6%), non-Hispanic (74.5%), and 32.5% of the cohort had at least 1 child. Regression analysis revealed brothers of BO patients had a higher likelihood of infertility (2.2% vs. 0.4% IHR-brother, P = 0.004) and their odds of infertility trended towards a higher likelihood (HR = 0.73, [0.3-2.0], P = 0.5) when compared to B/L IHR-brother (HR = 0.2, [0.1-0.6], P = 0.004). While not statistically significant for the BO cohort, this would suggest a trend towards a genetic association. Conclusions BO shows a genetic influence on sub-fertility, with increased infertility diagnoses among male siblings versus B/L IHR. Conversely, male siblings of B/L IHR patients exhibit significantly lower infertility rates, suggesting surgery-related factors predominate in adulthood infertility diagnoses post-pediatric B/L IHR. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: StreamDx, Inherent Bioscience, Turtle Health, Maimus, Carrot Fertility.