背景:随着社会经济条件的发展和对生育的态度的转变,自2000年代以来,延迟生育逐渐增加。年龄在生育率下降中起着重要作用。然而,我们对父亲年龄与生殖结局的关系知之甚少。
目的:探讨高龄父亲与精液质量的相关性,胚胎质量,怀孕,和IVF周期中的新生儿结局。
方法:在本研究中,在排除年龄≥35岁的女性伴侣后,我们分析了2020年6月至2023年3月在USTC第一附属医院接受体外受精周期的761对不孕夫妇的数据.根据男性的年龄将病例分为三组:<35岁(530对不育夫妇),35岁≤父亲年龄<40岁(125对不育夫妇),≥40岁(106对不育夫妇)。然后,我们比较了三组体外受精周期的一般临床数据,包括精液参数,胚胎参数,以及妊娠和新生儿出生结局。
结果:数据分析显示,父系年龄≥35岁组的不孕症持续时间和继发性不孕症发生率明显高于年龄<35岁组(均p<0.05)。我们还观察到≥40岁和<35岁组之间在正常受精率方面的显着差异,优质胚胎率,临床妊娠率,流产率,活产率,阿普加得分,低出生体重新生儿率(均p<0.05)。父系年龄≥40岁组临床妊娠率差异有统计学意义,流产率,活产率,多因素logistic回归分析(p均<0.05)。
结论:我们的研究结果表明,高龄(≥40岁)对胚胎质量有重大影响,妊娠结局,和新生儿结局。父亲年龄超过40岁是体外受精成功率的风险。
BACKGROUND: With the development of socio-economic conditions and a shift in attitudes towards fertility, there has been a gradual increase in delayed childbearing since the 2000s. Age plays a significant role in the decline of fertility. However, we know very little about the association of paternal age with reproductive outcomes.
OBJECTIVE: To investigate the correlation between advanced paternal age and semen quality, embryo quality, pregnancy, and neonatal outcomes in IVF cycles.
METHODS: In this study, after excluding female partners aged ≥35 years, we analyzed data from 761 infertile couples who underwent in vitro fertilization cycles at the First Affiliated Hospital of USTC between June 2020 and March 2023. Cases were classified into three groups according to the age of the male: <35 years (530 infertile couples), 35 years ≤ paternal age <40 years (125 infertile couples), and ≥40 years (106 infertile couples). Then, we compared the general clinical data arising from in vitro fertilization cycles between the three groups, including semen parameters, embryonic parameters, and pregnancy and neonatal birth outcomes.
RESULTS: Data analysis showed that the duration of infertility and the incidence of secondary infertility were significantly higher in paternal age ≥35 years groups than those aged <35 years (all p < 0.05). We also observed a significant difference between ≥40 years and <35 years groups in terms of the normal fertilization rate, high-quality embryo rate, clinical pregnancy rate, miscarriage rate, live birth rate, Apgar scores, and the low birth weight neonatal rate (all p < 0.05). The group with paternal age ≥40 years showed statistically significant differences in terms of clinical pregnancy rate, miscarriage rate, live birth rate, and low birth weight on multivariable logistic regression (all p < 0.05).
CONCLUSIONS: The results of our study indicate that advanced paternal age (≥40 years) has a significant impact on the embryo quality, pregnancy outcome, and neonatal outcome. Paternal age over 40 years is a risk for in vitro fertilization success rate.