Subfertility and atresias of the alimentary tract

In a descriptive study on alimentary tract atresias (ATA), a protective effect at parity 2 compared to parity 1 led us to expect an increased rate of fertility problems in mothers of these infants. To test the hypothesis we looked at sex hormones exposures around conception in 811 cases collected between 1982 and 1993 by the France Central-East registry of malformations. Exposure to progestins was compared for combined ATA (at two or more different levels) vs. single ATA with an odds ratio of 2.51 (95% CI 0.43-9.96). Although not statistically significant, this odds ratio raises the question of an association that would be interesting to test elsewhere. Combined ATA also occurred after stimulation of ovulation more often than did isolated forms of ATA: OR = 3.52 (95% CI 0.98-10.31). Stimulation of ovulation was more often reported for infants with ATA than for those with other malformations: OR = 1.87 (95% CI: 1.24-2.81). These indications in favor of an increased risk of ATA for infants born to subfertile mothers/couples should encourage other groups to test the hypothesis on available data sets.