Escudé-Logares Laura, Serrano-Novillo Clara, Uroz Laia, Galindo Anna, Márquez Carmen
Gravida, Hospital de Barcelona, 08034 Barcelona, Spain.
J Clin Med. 2024 Jan 14;13(2):457. doi: 10.3390/jcm13020457.
New social conditions and progress in ART have both contributed to the delay in parenthood in developed countries. While the effects of maternal age have been widely studied, paternal age is poorly understood, and there are no specific guides on ART techniques to treat its deleterious effects. It is known that there is an increase in sperm DNA fragmentation (SDF) in elderly men, and new sperm selection devices using microfluids have been developed. This study analyses 189 ICSI cycles with donor oocytes performed between January 2018 and February 2022. Spermatozoa were selected using an MSS device or density gradients, followed by ICSI fertilization and fresh/thawed embryo transfer. We assessed the association between the selection technique, paternal age (< or ≥45) and reproductive outcomes. Fertilization (FR), blastulation (BR), implantation (IR), live-birth (LBR) and miscarriage (MR) rates were calculated. The results showed significantly higher IR (57.7% vs. 42.5%) and LBR (42.9% vs. 30.3%) when applying MSS selection, and particularly higher BR, IR and LBR when the paternal age was equal to or over 45 years (BR: 64.4 ± 23% vs. 50.1 ± 25%, IR: 51.5% vs. 31.6% and LBR: 42.4% vs. 23.7%). We also found a negative correlation between BR and paternal age (r2 = 0.084). The findings show that MSS enhances success in assisted reproduction cycles with ICSI, especially in couples with advanced paternal age. We propose advanced paternal age as a new indicator for the application of sperm selection techniques that reduce fragmentation.
新的社会状况和辅助生殖技术（ART）的进步都导致了发达国家生育年龄的推迟。虽然母亲年龄的影响已得到广泛研究，但父亲年龄的影响却鲜为人知，并且对于治疗其有害影响的ART技术也没有具体指南。众所周知，老年男性的精子DNA碎片化（SDF）会增加，并且已经开发出了使用微流体的新型精子筛选装置。本研究分析了2018年1月至2022年2月期间进行的189个使用供体卵母细胞的卵胞浆内单精子注射（ICSI）周期。使用微流体精子筛选（MSS）装置或密度梯度法选择精子，随后进行ICSI受精和新鲜/解冻胚胎移植。我们评估了选择技术、父亲年龄（<或≥45岁）与生殖结局之间的关联。计算了受精率（FR）、囊胚形成率（BR）、着床率（IR）、活产率（LBR）和流产率（MR）。结果显示，应用MSS选择时，IR（57.7%对42.5%）和LBR（42.9%对30.3%）显著更高，当父亲年龄等于或超过45岁时，BR尤其是IR和LBR更高（BR：64.4±23%对50.1±25%，IR：51.5%对31.6%，LBR：42.4%对23.7%）。我们还发现BR与父亲年龄之间存在负相关（r2 = 0.084）。研究结果表明，MSS可提高ICSI辅助生殖周期的成功率，尤其是在父亲年龄较大的夫妇中。我们建议将父亲年龄较大作为应用减少碎片化的精子选择技术的新指标。
