Gonzalez Daniel C, Ory Jesse, Blachman-Braun Ruben, Nackeeran Sirpi, Best Jordan C, Ramasamy Ranjith
Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.
World J Mens Health. 2022 Jan;40(1):104-115. doi: 10.5534/wjmh.200195. Epub 2021 Apr 16.
Male ageing is often associated with defective sperm DNA remodeling mechanisms that result in poorly packaged chromatin and a decreased ability to repair DNA strand breaks. However, the impact of advanced paternal age on DNA fragmentation remains inconclusive. The aim of the present systematic review was to investigate the impact of advancing paternal age (APA) on DNA fragmentation.
We conducted a thorough search of listed publications in Scopus, PubMed, and EMBASE, in accordance with the PRISMA guidelines.
We identified 3,120 articles, of which nineteen were selected for qualitative analysis, resulting in a sample of 40,668 men. Of the 19 articles evaluating the impact of APA on DFI% (DNA fragmentation Index) included, 4 were on Normozoospermic and subfertile men, 3 on normozoospermic, Oligoasthenoteratozoospermic and Teratozoospermic, 6 on fertile and infertile men, 4 on just infertile men, and 2 evaluated a general population. Seventeen of the ninrnteen studies demonstrated APA's effect and impact on DFI%.
Although there was no universal definition for APA, the present review suggests that older age is associated with increased DFI. In elderly men with normal semen parameters, further studies should be performed to assess the clinical implications of DFI, as a conventional semen analysis can often fail to detect an etiology for infertility.
男性衰老通常与精子DNA重塑机制缺陷有关，这会导致染色质包装不佳以及DNA链断裂修复能力下降。然而，父亲年龄增长对DNA碎片化的影响仍无定论。本系统评价的目的是研究父亲年龄增长（APA）对DNA碎片化的影响。
我们按照PRISMA指南，对Scopus、PubMed和EMBASE中列出的出版物进行了全面检索。
我们共识别出3120篇文章，其中19篇被选作定性分析，形成了一个包含40668名男性的样本。在评估APA对DFI%（DNA碎片化指数）影响的19篇文章中，4篇针对正常精子数和亚生育男性，3篇针对正常精子数、少弱畸精子症和畸精子症男性，6篇针对可育和不育男性，4篇仅针对不育男性，2篇评估了普通人群。19项研究中的17项证明了APA对DFI%的影响。
尽管对于APA没有统一的定义，但本综述表明年龄较大与DFI增加有关。对于精液参数正常的老年男性，应进一步开展研究以评估DFI的临床意义，因为传统的精液分析往往无法检测出不育的病因。
