男性高齡並不明顯影響IVF懷孕率及活產率

Hum Reprod. 2014 Oct 10;29(10):2114-22. doi: 10.1093/humrep/deu189. Epub 2014 Jul 28.

Paternal age and assisted reproductive outcomes in ICSI donor oocytes: is there an effect of older fathers?

Beguería R1, García D2, Obradors A1, Poisot F1, Vassena R3, Vernaeve V4.

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Abstract

STUDY QUESTION:

Does paternal age affect semen quality and reproductive outcomes in oocyte donor cycles with ICSI?

SUMMARY ANSWER:

Paternal age is associated with a decrease in sperm quality, however it does not affect either pregnancy or live birth rates in reproductive treatments when the oocytes come from donors <36 years old and ICSI is used.

WHAT IS KNOWN ALREADY:

The weight of evidence suggest that paternal age is associated with decreasing sperm quality, but uncertainty remains as to whether reproductive outcomes are affected. Although developed to treat severe sperm factor infertility, ICSI is gaining popularity and is often used even in the presence of mild male factor infertility.

STUDY DESIGN, SIZE, DURATION:

A retrospective cohort study spanning the period between February 2007 and June 2010. A total of 4887 oocyte donation cycles were included.

PARTICIPANTS/MATERIALS, SETTING, METHODS:

Fertilization was carried out by ICSI in all cycles included, and the semen sample used was from the male partner in all cases. The association of male age with semen parameters (volume, concentration, percentage of motile spermatozoa) was analyzed by multiple analysis of covariance. The association of male age with reproductive outcomes (biochemical pregnancy, miscarriage, ongoing pregnancy and live birth rate) was modeled by logistic regression, where the following covariates were introduced: donor age, recipient age, semen state (fresh versus frozen) and number of transferred embryos (3 and 2 versus 1).

MAIN RESULTS AND THE ROLE OF CHANCE:

We identified a significant relationship between paternal age and all sperm parameters analyzed: for every 5 years of age, sperm volume decreases by 0.22 ml (P < 0.001), concentration increases by 3.1 million sperm/ml (P = 0.003) and percentage motile spermatozoa decreases by 1.2% (P < 0.001). No differences were found in reproductive outcomes (biochemical pregnancy, miscarriage, clinical pregnancy, ongoing pregnancy and live birth) among different male age groups.