diagnoses (including live births, abortions, ectopic pregnancies, pregnancy-related complications) from 8/2/1990 to 5/31/1992 and who responded to mailed survey: GW-exposed conceptions (n = 415), GW postwar conceptions (n = 298), NDVs (n = 427)

pregnancies, pregnancy-related complications (ICD-9-CM codes 640-676); confirmed by discharge diagnostic data

spontaneous abortions, 68 vs 39 (RR 2.92, 95% CI 1.87-4.56); ectopic pregnancies, 32 vs 6 (RR 7.70, 95% CI 3.00-19.8); GWV vs NDV exposed conceptions: spontaneous abortions, 48 vs 39 (RR 1.44, 95% CI 0.91-2.29); ectopic pregnancies, 10 vs 6 (RR 1.91, 95% CI 0.67-5.46)

of adverse outcome

information on smoking, alcohol, caffeine, other known risk factors for fetal loss; possible limited generalizability due to restriction to military hospital admissions; recall bias Strengths: confirmation with discharge data, assessed GW-exposed and postwar conceptions


Ishoy et al., 2001a (Vol. 4)

Cross-sectional Participation rates: GWVs, 83.6%; NDVs, 57.8%

Danish Gulf War Study, GWVs (n = 661) NDVs (n = 215)

Self-reports of sexual problems (including reduced libido); measured male reproductive hormones: serum concentrations of LH, FSH, testosterone, inhibin B

Male GWVs vs NDVs: self-reported sexual problems, 12.0% vs 3.7% (p < 0.001); reproductive hormones, no significant difference; suspected oligospermia, FSH ≥ 10 IU/L, inhibin B ≤ 80 pg/mL, 1.6% vs 1.6%; fertility rates, spontaneous abortion, congenital malformations: no differences

Age; BMI available; stratified on deployment organization, duration of deployment

Limitations: limited control for confounding, small numbers for study of fertility rates, congenital malformations Strengths: measurement of hormones objective and unbiased

Maconochie et al., 2004 (Vol. 4)

Retrospective cohort (same cohort as Doyle et al., 2004)

Male UK veterans fathering or trying to father pregnancies after GW and before 8/97 GWV (n = 10,465) NDV (n = 7376)

Self-reported fertility problems: tried unsuccessfully for > 1 year and consulted doctor; type I infertility: never achieving pregnancy; type II infertility: never achieving live birth;

Adjusted ORs: fertility problems, 732/10,465 vs 370/7376: (OR 1.38, 95% CI 1.20-1.60); type I 259/10,465 vs 122/7376 (OR 1.41, 95% CI 1.05-1.89); type II 356/10,465 vs 166/7376 (OR 1.50, 95% CI 1.18-1.89); time to conception > 1 year for planned pregnancies,

Maternal and paternal age at first infertility consult or post-GW conception, year of first consult or conception, pre-GW pregnancy history, military service and rank, smoking, alcohol,

Response rates: GWVs, 53%; NDVs, 42% Limitations: low response rates, possible recall bias, clinically evaluated only 40% Strengths: attempted clinical evaluation,

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