The effect of paternal age on outcome in assisted reproductive technology using the ovum donation model

摘要

Objective: To determine the effect of paternal age (PA) on implantation and live birth rates in an ovum donation program. Design: Retrospective study. Methods: A total of 237 ovum donor cycles were reviewed. All donors were stimulated with gonadotrophin-releasing hormone agonist (GnRHa) downregulation and human menopausal gonadotropin. Recipients were prepared with GnRHa downregulation and estradiol/progesterone replacement. Embryo transfers were done at blastocyst stage under ultrasound guidance. The effect of PA on outcome was analyzed controlling for number and grade of embryos transferred. Outcome was not pregnant (NP), spontaneous abortion (SAb), and live births (LBs). Results: Of the 237 cycles, 36 resulted in NP (15.2%), 39 in SAb (16.5%), and 162 in LB (68.4%). The mean PA (MPA) was significantly different between the 3 groups, and implantation rates also declined with increasing MPA (P .01). Overall, the mean number and grade of embryos transferred were 2.1+0.4 and 1.3 + 0.4, respectively. The NP couples had more embryos of poorer grade than SAb and LB couples (P <.05), but there were no differences between SAb and NP couples (P >.85). Logistic regression analysis demonstrated a 26% lower odds of live birth rate with each 5-year increase in PA (P .01). Conclusions: Advanced PA has an adverse impact on assisted reproductive technology (ART) outcome. After adjusting for number and embryo grades transferred, a younger PA has a more favorable ART outcome.