Service de chirurgie gynécologique et médecine de la reproduction, CHU Bordeaux, Hôpital Pellegrin, 33000, Bordeaux, France.
Service de biologie et médecine de la reproduction, CHU de Nantes, CHU Nantes, Nantes Université, 38 Boulevard Jean Monnet, 44093, Nantes, France.
J Assist Reprod Genet. 2023 Mar;40(3):617-626. doi: 10.1007/s10815-023-02714-1. Epub 2023 Jan 18.
While delayed parenthood is increasing worldwide, the effect of paternal age on in vitro fertilization (IVF) outcomes remains unclear. The egg donation model appears to be relevant to studying the independent impact of paternal age on clinical outcome, but the available studies are heterogeneous and contradictory. This systematic review and meta-analysis aimed to assess the relationship between paternal age and live birth rate (LBR) in egg donation cycles.
A systematic search of the literature was conducted in PubMed, Embase, and the Cochrane Library from inception to June 30, 2021. All studies on egg donation cycles where LBR is reported according to male age were included. Study selection, bias assessment, and data extraction were performed by two independent reviewers according to the Cochrane methods.
Eleven studies involving 10,527 egg donation cycles were finally included. The meta-analysis showed a slight but significant and linear decrease in LBR with increasing paternal age (estimate - 0.0055; 95% CI (- 0.0093; - 0.0016), p = 0.006), with low heterogeneity (I = 25%). No specific threshold was identified. A similar trend toward decreased clinical pregnancy rate with advancing paternal age was found but did not reach statistical significance (p = 0.07).
This meta-analysis demonstrates that increasing paternal age is associated with a slight but significant and linear decrease in the live birth rate in egg donation cycles, with no apparent threshold effect. Although this requires further confirmation, this information is important for counseling men who are considering delayed childbearing.
尽管全球范围内晚育现象日益增多，但父龄对体外受精（IVF）结局的影响仍不清楚。供卵模型似乎是研究父龄对临床结局的独立影响的相关模型，但现有研究存在异质性和矛盾。本系统评价和荟萃分析旨在评估供卵周期中父龄与活产率（LBR）之间的关系。
从建库至 2021 年 6 月 30 日，我们在 PubMed、Embase 和 Cochrane 图书馆中进行了系统文献检索，纳入了所有报告了根据男性年龄得出的活产率的供卵周期研究。两名独立的评审员按照 Cochrane 方法进行了研究选择、偏倚评估和数据提取。
最终纳入了 11 项涉及 10527 个供卵周期的研究。荟萃分析显示，随着父龄的增加，LBR 呈轻微但显著的线性下降（估计值-0.0055；95%CI（-0.0093；-0.0016），p=0.006），异质性较低（I=25%）。未确定特定的阈值。随着父龄的增加，临床妊娠率呈下降趋势，但未达到统计学意义（p=0.07）。
本荟萃分析表明，在供卵周期中，父龄的增加与活产率的轻微但显著和线性下降相关，没有明显的阈值效应。尽管这需要进一步证实，但这些信息对于考虑延迟生育的男性进行咨询非常重要。
