在使用捐赠卵子的人类体外受精或卵胞浆内单精子注射后，父亲年龄较大并不影响与医学相关的产科和围产期结局。
Advanced Paternal Age Does Not Affect Medically-Relevant Obstetrical and Perinatal Outcomes following IVF or ICSI in Humans with Donated Oocytes.
作者信息
Navarro-Gomezlechon Ana, Gil Juliá María, Hervás Irene, Mossetti Laura, Rivera-Egea Rocío, Garrido Nicolás
机构信息
IVI Foundation-Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain.
IVF Laboratory, IVIRMA Roma, Via Federico Calabresi, 11, 00169 Rome, Italy.
出版信息
J Clin Med. 2023 Jan 28;12(3):1014. doi: 10.3390/jcm12031014.
BACKGROUND
Concomitant with delays in childbearing, concerns have been raised of whether advanced paternal age is associated with adverse reproductive outcomes, but the evidence is controversial in part due to the uncertain threshold in which to consider advanced paternal age and confounding maternal factors. This retrospective study aimed to evaluate the effect of paternal age on reproductive outcomes related to the pregnancy and perinatal health of the offspring.
METHODS
We retrospectively evaluated 16,268 cases of patients who underwent IVF or ICSI (using autologous sperm and donated oocytes, between January 2008 and March 2020, at Spanish IVIRMA clinics. Patients were divided based on paternal age at conception [≤30 ( = 204), 31-40 ( = 5752), and >40 years ( = 10,312)], and the differences in obstetrical and perinatal outcomes were analyzed by descriptive analysis, followed by univariate and multivariate analysis.
RESULTS
Fathers 31-40 and >40 years old were associated with lower odds of caesarean delivery [AOR 0.63 (95% CI, 0.44-0.90; = 0.012) and AOR 0.61 (95% CI, 0.41-0.91; = 0.017), respectively] and longer pregnancies [ARC 5.09 (95% CI, 2.39-7.79; < 0.001) and ARC 4.54 (95% CI, 1.51-7.58; = 0.003), respectively] with respect to fathers ≤30 years old. Furthermore, fathers aged 31-40 years old had lower odds of having a female infant (AOR, 0.70; 95% CI, 0.49-0.99; = 0.045) than those ≤30. The rest of obstetrical and perinatal outcomes, which we deemed more medically-relevant as they were considered serious for health, were comparable between groups with our adjusted model.
CONCLUSIONS
Despite this hopeful message to fathers of advanced paternal age, future studies should consider the short- and long-term outcomes of the offspring and try to better elucidate the associations of advanced paternal age with reproductive outcomes and the molecular mechanisms underlying the observed associations.
背景
随着生育延迟，人们开始关注父亲年龄偏大是否与不良生殖结局有关，但部分证据存在争议，这在一定程度上是由于难以确定父亲年龄偏大的阈值以及母亲因素的混杂作用。这项回顾性研究旨在评估父亲年龄对与后代妊娠和围产期健康相关的生殖结局的影响。
方法
我们回顾性评估了2008年1月至2020年3月期间在西班牙IVIRMA诊所接受体外受精（IVF）或卵胞浆内单精子注射（ICSI）（使用自体精子和捐赠卵子）的16268例患者。根据受孕时父亲的年龄将患者分为三组[≤30岁（n = 204）、31 - 40岁（n = 5752）和>40岁（n = 10312）]，通过描述性分析分析产科和围产期结局的差异，随后进行单因素和多因素分析。
结果
与≤30岁的父亲相比，31 - 40岁和>40岁的父亲剖宫产几率较低[调整后比值比（AOR）分别为0.63（95%置信区间，0.44 - 0.90；P = 0.012）和AOR 0.61（95%置信区间，0.41 - 0.91；P = 0.017）]，妊娠时间较长[平均差（ARC）分别为5.09（95%置信区间，2.39 - 7.79；P < 0.001）和ARC 4.54（95%置信区间，1.51 - 7.58；P = 0.003）]。此外，31 - 40岁的父亲生育女婴的几率低于≤30岁的父亲（AOR，0.70；95%置信区间，0.49 - 0.99；P = 0.045）。在我们的调整模型中，其余我们认为在医学上更相关（因其被视为对健康有严重影响）的产科和围产期结局在各组之间具有可比性。
结论
尽管这一信息对父亲年龄偏大的情况来说是个好消息，但未来的研究应考虑后代的短期和长期结局，并努力更好地阐明父亲年龄偏大与生殖结局之间的关联以及所观察到的关联背后的分子机制。
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