Background
Literature concerning the impact of Multiple Endocrine Neoplasia Type 1 (MEN 1) on fertility is limited to case reports. We examined the intrinsic impact of MEN 1 on fertility in a multigenerational MEN 1 cohort.
Methods
All MEN 1 positive (MEN 1+, n=63) and MEN 1 negative (MEN 1-, n=75) descendants of a common founder born between 1825 and 1951 were included. Review of birth, death, marriage and medical records provided data on date of birth and death, gender, MEN 1 status and the number of pregnancies and children per parent.
Results
Compared to MEN 1- parents, MEN 1+ parents had more children (RR 1.32, 1.04-1.66) and live births (RR 1.36, 1.15-1.61) with no excess of stillbirths (RR 1.19, 0.23-6.08). Compared to the era-matched Tasmanian fertility rate, MEN 1+ parents had more children (4.87±4.11 vs 3.40±0.61, p=0.006), whereas MEN 1- parents had similar numbers of children (3.67±3.27 vs 3.36±0.62, p=0.55). MEN 1+ parents had a similar number of MEN 1+ and MEN 1- offspring (2.1±1.9 vs 2.5±2.3, p=0.31) with observed MEN 1+ offspring frequency consistent with that expected for autosomal dominant MEN 1 (p=0.23). Indirectly assessed miscarriage rate was similar between MEN 1+ and MEN 1- mothers (p=0.77). Clinically overt pituitary disease reduced MEN 1+ kindred member likelihood of parenthood (33% vs 97%, p<0.001).
Conclusion
MEN 1-related pathology directly impaired the reproductive potential of a subset of individuals, but there was no adverse impact of MEN 1 on cohort fertility overall.