Paternal age over 50 years decreases assisted reproductive technology (ART) success: A single UK center retrospective analysis

Abstract

Introduction: To study whether paternal age exerts an effect, independent of maternal age, on the outcomes of fresh in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI) cycles. Semen quality deteriorates with increasing paternal age; however, there is conflicting evidence for any impact paternal age may have on the outcome of IVF/ICSI. Several retrospective and prospective cohort studies have shown that paternal age increases the miscarriage rate and reduces the live birth rate. Some studies have shown no effect of paternal age on live birth rate or miscarriage rate. Studies involving donor oocytes have tended to show no independent effect of paternal age on assisted reproductive technology (ART) outcomes. The age at which paternal age may exert a significant deleterious effect on outcome is not known and there is no limit to paternal age in IVF/ICSI treatment. Material and methods:A single-center retrospective cohort study was carried out at the Centre for Reproductive and Genetic Health, London, UK. Included in the analysis were all couples with primary or secondary infertility undergoing IVF/ICSI cycles in which the male partner produced a fresh semen sample and the cycle proceeded to fresh embryo transfer. All cycles of IVF/ICSI that used donor oocytes-donor sperm, frozen sperm, cycles leading to embryo storage and cycles including preimplantation genetic testing (PGT-A/PGT-M)-were excluded from analysis. The primary outcome was live birth rate and secondary outcomes were clinical pregnancy rate and miscarriage rate. Multivariate logistic regression analysis with live birth as a dependent variable and maternal and paternal age class as independent variables was performed. Results: During the study period there were 4833 cycles, involving 4271 men, eligible for analysis; 1974/4833 (40.8%, 95% confiene intervals [CI] 39.5-42.2%) cycles resulted in a live birth. A significantly lower proportion of men over 51 years met World Health Organization semen analysis criteria (56/133, [42.1%, 95% CI 34.1-50.6]) compared with men under 51 years of age (2530/4138 [61.1%, 95% CI 60.0-62.6]) (p = 0.001). Both maternal and paternal age were retained in the multivariate model | 1859 MORRIS et al. | MATERIAL AND ME THODSThis was a retrospective cohort study conducted at the Centre for Reproductive and Genetic Health, London, UK.Data for in vitro fertilization (IVF) cycles carried out in our unit are held on a clinical database (IDEAS, version 6 Mellowood Medical software). We created a database query to retrieve data on all couples that underwent an IVF or intracytoplasmic sperm injection (ICSI) cycle with fresh embryo transfer from 1 December 2009 to 1 August 2018. We excluded cycles that used donor gametes (oocytes/sperm) and those that used frozen or surgically retrieved sperm. Our study did not include donor oocyte cycles to allow analysis of the effect and for all maternal age subgroups the probability of live birth decreased with paternal age over 50 years (odds ratio [OR] 0.674, 95% CI 0.482-0.943) (p = 0...

Risk Factors of Pregnancy Failure in Infertile Patients Undergoing Assisted Reproductive Technology

“… 46 The results of a British study showed that paternal age over 50 years decreased the success rate of ART. 47 However, some studies have shown that paternal age was not associated with adverse IVF outcomes. 48 , 49 In this study, paternal age was not associated with pregnancy failure after ART in infertile patients.…”

Advanced Paternal Age and Future Generations

“…Advanced paternal age has been associated with various adverse outcomes with assisted reproductive technologies (ARTs) including poor embryo quality, increased miscarriage rates, reduced fertilization, implantation, pregnancy, and live birth rates ( 40 – 48 ). Inconsistency and conflicting data exist ( 49 – 51 ) likely due to the results of confounders and bias in the design of the studies, small sample size, retrospective nature and heterogeneity of the subjects.…”

Reproductive axis ageing and fertility in men

“…However, there were no significant differences in live birth or miscarriage where the female partner was < 35 years of age [ 91 ]. A single centre retrospective cohort study of 4833 ART cycles involving 4271 men reported also significantly lower probability of live birth with paternal age > 50 years [ 92 ]. In a recent meta-analysis, data extracted from 28 studies (16 autologous oocyte studies; 12 donor oocyte studies) were collated to analyse the effect of paternal age at 30–50 years.…”