semen quality; time to conception; attempted clinical confirmation from both partners’ physicians

845/9968 vs 528/7408 (OR 1.18, 95% CI 1.04-1.34) (increase in risk stable with time since GW)

pregnancy order

information on nonresponders available

McDiarmid et al., 2009 (Update)

Case series (follow-up of McDiarmid et al., 2000, 2001, 2004, 2005, 2006, and 2007)

35 GWVs exposed to DU during friendly-fire incidents in 1991, divided into low- and high-exposure groups; examined in April-June 2007, 16-year follow-up

Urinary and serum markers, semen analyses, neuroendocrine measures

No adverse DU effects on semen parameters or serum concentrations of testosterone, LH, or FSH Serum prolactin concentrations non-significantly above normal limits in both groups


Very small cohort, no control for potential confounders

Sexual dysfunction

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

Cross-sectional (elaboration of findings in Ishoy et al., 2001a)

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

Self-reported sexual problems

Male GWVs vs NDVs: sexual problems (80% decreased libido), 79/661 vs 8/215 (OR 2.9, 95% CI 1.4-6.0) (among GWVs associated with “having seen killed or wounded victims”; “having been threatened with arms”; “having watched colleagues being seriously threatened or shot at”; water hygienic environment)


Limitations: small study, self-reported soft outcomes and exposures

NOTE: BMI = body mass index; CDC = Centers for Disease Control and Prevention; CI = confidence interval; DU = depleted uranium; FSH = follicle-stimulating hormone; GW = Gulf War; GWV = Gulf War veterans; HFM = hemifacial microsomia; LH = luteinizing hormone; NDV = nondeployed veterans; NIFS = Nuclear Industry Family Study; OR = adjusted odds ratio; RR = adjusted risk ratio.

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