Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory Reproductive Center, Atlanta, Georgia.
Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.
Fertil Steril. 2021 Aug;116(2):380-387. doi: 10.1016/j.fertnstert.2021.03.033. Epub 2021 Apr 25.
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.
Retrospective cohort.
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.
描述美国辅助生殖技术（ART）周期中的父亲年龄特征，并评估父亲年龄对 ART 周期和围产期结局的影响。
回顾性队列研究。
不适用。
2017 年报告的所有新鲜、非供体、非取消的体外受精（IVF）周期。
不适用。
主要结局为每个周期开始和每个胚胎移植的宫内妊娠、活产（≥20 周）和流产（<20 周）。次要结局为单胎和双胎妊娠的足月活产（≥37 周）。采用修正泊松回归估计父亲年龄与周期和围产结局之间的关联，总体和按母亲年龄分层。
在 77209 例新鲜非供体、非取消的 IVF 周期中，平均父亲年龄为 37.8 ± 6.3 岁，平均母亲年龄为 35.5 ± 4.6 岁。与父亲年龄≤45 岁相比，父亲年龄≥46 岁与每个周期的妊娠可能性降低相关（调整风险比[aRR]0.81；95%置信区间[CI]0.76-0.87）和每次转移（aRR 0.85；95% CI 0.81-0.90），以及每个周期的活产可能性降低（aRR 0.76；95% CI 0.72-0.84）和每次转移（aRR 0.82；95% CI 0.77-0.88），在控制母亲年龄和其他混杂因素后。当限制在年龄<35 岁的女性中时，与男性年龄≤45 岁的夫妇相比，年龄≥46 岁的夫妇的活产率或流产率没有显著差异。
与父亲年龄≤45 岁相比，父亲年龄≥46 岁与 IVF 中夫妇的妊娠和活产可能性降低相关。父亲年龄的负面影响在年龄≥35 岁的女性中最为显著，这可能是因为母亲年龄是 ART 结果的更强预测因素。
