Influence of paternal age on assisted reproductive technology cycles and perinatal outcomes

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Authors:

Audrey M. Marsidi, M.D., Lauren M. Kipling, M.P.H., Jennifer F. Kawwass, M.D., Akanksha Mehta, M.D.

Abstract:

Objective

To characterize paternal age among assisted reproductive technology (ART) cycles performed in the United States and to evaluate the influence of paternal age on ART cycles and perinatal outcomes.


Design

Retrospective cohort.


Setting

Not applicable.


Patient(s)

All reported fresh, nondonor, noncancelled in vitro fertilization (IVF) cycles performed in 2017.


Intervention(s)

Not applicable.


Main Outcome Measure(s)

The primary outcomes were intrauterine pregnancy, live birth (≥20 weeks), and miscarriage (<20 weeks) per cycle start and per embryo transfer. The secondary outcomes were full-term live birth (≥37 weeks) among singleton and twin gestations. Modified Poisson regression was performed to estimate associations between paternal age and cycle and perinatal outcomes, overall and stratified by maternal age.


Result(s)

Among 77,209 fresh nondonor, noncancelled IVF cycles, the average paternal age was 37.8 ± 6.3 years and the average maternal age was 35.5 ± 4.6 years. Compared with paternal age ≤45 years, paternal age ≥46 years was associated with a lower likelihood of pregnancy per cycle (adjusted risk ratio [aRR] 0.81; 95% confidence interval [CI] 0.76–0.87) and per transfer (aRR 0.85; 95% CI 0.81–0.90), as well as a lower likelihood of live birth per cycle (aRR 0.76; 95% CI 0.72–0.84) and per transfer (aRR 0.82; 95% CI 0.77–0.88) after controlling for maternal age and other confounders. When restricted to women aged <35 years, there were no significant differences in the rates of live birth or miscarriage among couples in which the men were aged ≤45 years compared with those aged ≥46 years.


Conclusion(s)

Compared with paternal age ≤45 years, paternal age ≥46 years is associated with a lower likelihood of pregnancy and live birth among couples undergoing IVF. The negative effect of paternal age is most notable among women aged ≥35 years, likely because maternal age is a stronger predictor of ART outcome.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.