精液参数对高龄父亲与 IVF 临床结局关联的中介效应：一项 10 年回顾性队列研究。

Semen parameters' mediation effect on the association between advanced paternal age and IVF clinical outcomes: A 10-year retrospective cohort study.

机构信息

Department of Obstetrics and Gynecology, Center of Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

出版信息

Maturitas. 2023 Jul;173:20-27. doi: 10.1016/j.maturitas.2023.04.011. Epub 2023 May 4.

DOI:10.1016/j.maturitas.2023.04.011

PMID:37182387

Abstract

OBJECTIVE

To explore the mediation between advanced paternal age and the outcomes of in vitro fertilization (IVF) in a female-adjusted cohort.

METHODS

The study retrospectively included couples undergoing IVF cycles between 2011 and 2020, and whose female partner was free of medical conditions that would significantly worsen clinical outcomes. Data on patient medical conditions, clinical data, and follow-up information were collected. Causal mediation effect analysis adopting both linear/logistic regression and mixed-effects models was carried out to evaluate the effect of paternal age on the outcomes.

RESULTS

21,959 IVF cycles were included in the study. Semen volume, sperm motility and sperm morphology were significantly associated (P value <0.05) with paternal age. A lower fertilization rate was associated with increased paternal age after adjustment for maternal age (adjusted OR = 0.800; 95 % CI, 0.678, 0.943; P value = 0.008). Mediation analysis revealed that A-level sperm rate and progressive rate respectively mediated 37.0 % and 41.0 % of the association between paternal age and fertilization rate.

CONCLUSION

Sperm motility rate, especially A-level sperm rate and rapid progressive rate, mediated the association between advanced paternal age and lower fertilization rate in the cycles.

摘要

目的

在女性调整队列中探索高龄父亲与体外受精（IVF）结局之间的中介作用。

方法

本研究回顾性纳入了 2011 年至 2020 年间进行 IVF 周期的夫妇，且其女性伴侣没有可能显著恶化临床结局的医学疾病。收集了患者的医学状况、临床数据和随访信息。采用线性/逻辑回归和混合效应模型进行因果中介效应分析，以评估父亲年龄对结局的影响。

结果

共纳入 21959 个 IVF 周期。精液量、精子活力和精子形态与父亲年龄显著相关（P 值<0.05）。调整母亲年龄后，受精率随父亲年龄的增加而降低（调整后 OR=0.800；95%CI，0.678，0.943；P 值=0.008）。中介分析显示，A级精子率和快速前进率分别介导了父亲年龄与受精率之间的 37.0%和 41.0%的关联。