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男性年龄和精液参数均不影响体外受精的临床妊娠或活产结局。

Neither male age nor semen parameters influence clinical pregnancy or live birth outcomes from IVF.

作者信息

Mariappen Uma, Keane Kevin N, Hinchliffe Peter M, Dhaliwal Satvinder S, Yovich John L

机构信息

Hospital Tengku Ampuan Rahimah (HTAR), Klang, Malaysia; PIVET Medical Centre, Leederville, Perth, WA 6007, Australia.

PIVET Medical Centre, Leederville, Perth, WA 6007, Australia; School of Pharmacy & Biomedical Science, Curtin University, Perth, WA 6102, Australia.

出版信息

Reprod Biol. 2018 Dec;18(4):324-329. doi: 10.1016/j.repbio.2018.11.003. Epub 2018 Nov 30.

Abstract

Advanced age is an increasing trend for both males and females seeking in vitro fertilization (IVF). This retrospective cohort study investigated the outcomes of 1280 IVF-related treatment cycles, selecting the first treatment for couples utilizing autologous gametes and who underwent single fresh embryo transfer. Males aged 40-49 years had a 52% reduction in normal sperm motility, while it was markedly reduced by 79% at 50 years or older. However, neither semen parameters nor male age were predictive of clinical pregnancy or live birth chance. In a combination of age groups, cases with Younger Females had the greatest chance of successful outcomes and this was independent of having a younger or older male partner. Specifically, Young Female-Young Male combinations (≤ 35 years) were the most likely to succeed in achieving a clinical pregnancy or live birth (OR 2.84, p < 0.0005 and 3.34, p < 0.0005, respectively), while the Young Female-Old Male group (≤ 35 and >35 years, respectively) had a similar increased chance (OR 2.07, p < 0.0005 and 2.78, p < 0.0005, respectively). This trend strengthened as the Female age cut-off was increased to 38 years and the Male age cut-off increased to 40 or 42 years. Consistently, the groups comprising a Young Female with either a Young Male or Old Male outperformed the groups with an Old Female. Our finding confirms reduced fecundity with advancing female age as the most important parameter. The outcomes were not significantly influenced by semen parameters or male age with respect to the likelihood of clinical pregnancy or live birth.

摘要

寻求体外受精(IVF)的男性和女性的年龄都呈现出增长趋势。这项回顾性队列研究调查了1280个与IVF相关的治疗周期的结果,选取了使用自体配子且进行单次新鲜胚胎移植的夫妇的首次治疗。40至49岁的男性正常精子活力降低了52%,而50岁及以上则显著降低了79%。然而,精液参数和男性年龄都不能预测临床妊娠或活产几率。在不同年龄组的组合中,年轻女性组获得成功结果的机会最大,这与男性伴侣的年龄大小无关。具体而言,年轻女性-年轻男性组合(≤35岁)最有可能成功实现临床妊娠或活产(OR分别为2.84,p<0.0005和3.34,p<0.0005),而年轻女性-老年男性组(分别为≤35岁和>35岁)也有类似的增加机会(OR分别为2.07,p<0.0005和2.78,p<0.0005)。随着女性年龄界限提高到38岁,男性年龄界限提高到40或42岁,这种趋势更加明显。一致的是,由年轻女性与年轻男性或老年男性组成的组优于老年女性组。我们的研究结果证实,随着女性年龄增长生育力下降是最重要的参数。就临床妊娠或活产的可能性而言,精液参数或男性年龄对结果没有显著影响。

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