Does advanced paternal age affect outcomes following assisted reproductive technology? A systematic review and meta-analysis. Issue 2 (August 2022)

• Record Type: Journal Article
• Authors: Murugesu, Sughashini; Kasaven, Lorraine S.; Petrie, Aviva; Vaseekaran, Anusiya; Jones, Benjamin P.; Bracewell-Milnes, Timothy; Barcroft, Jennifer F.; Grewal, Karen J.; Getreu, Natalie; Galazis, Nicolas; Sorbi, Flavia; Saso, Srdjan; Ben-Nagi, Jara
• Is Part Of: Reproductive biomedicine online. Volume 45:Issue 2(2022)
• Page Start: 283
• Page End: 331
• Publication Date: 2022-08
• Subjects: Clinical pregnancy -- Fertility -- IVF, Live birth -- Miscarriage rate -- Paternal age; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2022.03.031
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Infertility affects more than 14% of couples, 30% being caused by male factor infertility. This meta-analysis includes 28 studies, selected according to PRISMA guidelines. Data were extracted from these studies to collate cycles separating paternal age at 30, 35, 40, 45 and 50 years (±1 year). Primary outcomes of interest were clinical pregnancy, live birth and miscarriage rates. Secondary outcomes were the number of fertilized eggs, cleavage-stage embryos and blastocysts, and embryo quality per cycle. Fixed-effects and random-effects models giving pooled odds ratios (OR) were used to assess the effect of paternal age. This meta-analysis included a total 32, 484 cycles from 16 autologous oocyte studies and 12 donor oocyte studies. In autologous cycles, a statistically significant effect of paternal age <40 years was noted in clinical pregnancy (OR 1.65, 95% confidence interval [CI] 1.27–2.15), live birth (OR 2.10, 95% CI 1.25–3.51) and miscarriage (OR 0.74, 95% CI 0.57–0.94) rates. Paternal age <50 years significantly reduced miscarriage rate (OR 0.68, 95% CI 0.54–0.86), and increased blastocyst rate (OR 1.61, 95% CI 1.08–2.38) and number of cleavage-stage embryos (OR 1.67, 95% CI 1.02–2.75) in donor oocyte cycles, where maternal age is controlled. This is an important public and societal health message highlighting the need to also consider paternal age alongside maternal age when planning a family.