Queen Charlotte's Hospital, Hammersmith Hospital Campus, London, UK.
Division of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmith Hospital Campus, London, UK.
Reprod Biomed Online. 2022 Aug;45(2):283-331. doi: 10.1016/j.rbmo.2022.03.031. Epub 2022 Apr 10.
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.
不孕不育影响超过 14%的夫妇，其中 30%是由男性因素引起的。这项荟萃分析包括 28 项研究，这些研究是根据 PRISMA 指南选择的。从这些研究中提取数据，以整理出父亲年龄分别为 30、35、40、45 和 50 岁（±1 年）的周期之间的差异。主要观察结果是临床妊娠、活产和流产率。次要结果是每个周期受精的卵子、卵裂期胚胎和囊胚数量，以及胚胎质量。使用固定效应和随机效应模型计算汇总优势比（OR），以评估父亲年龄的影响。这项荟萃分析共纳入了 16 项自体卵研究和 12 项供卵研究的 32484 个周期。在自体周期中，父亲年龄<40 岁与临床妊娠（OR 1.65，95%置信区间 [CI] 1.27-2.15）、活产（OR 2.10，95% CI 1.25-3.51）和流产（OR 0.74，95% CI 0.57-0.94）率的统计学显著相关。父亲年龄<50 岁显著降低了流产率（OR 0.68，95% CI 0.54-0.86），并增加了囊胚率（OR 1.61，95% CI 1.08-2.38）和卵裂期胚胎数量（OR 1.67，95% CI 1.02-2.75），这在控制了母亲年龄的供卵周期中是如此。这是一个重要的公共和社会健康信息，强调在规划家庭时，除了考虑母亲年龄外，还需要考虑父亲年龄。
