Advanced Paternal Age Does Not Affect Medically-Relevant Obstetrical and Perinatal Outcomes following IVF or ICSI in Humans with Donated Oocytes

Ana Navarro-Gomezlechon; María Gil Juliá; Irene Hervás; Laura Mossetti; Rocío Rivera-Egea; Nicolás Garrido

doi:10.3390/jcm12031014

Advanced Paternal Age Does Not Affect Medically-Relevant Obstetrical and Perinatal Outcomes following IVF or ICSI in Humans with Donated Oocytes

J Clin Med. 2023 Jan 28;12(3):1014. doi: 10.3390/jcm12031014.

Authors

Ana Navarro-Gomezlechon¹, María Gil Juliá¹, Irene Hervás^{1

2}, Laura Mossetti^{1

2}, Rocío Rivera-Egea³, Nicolás Garrido¹

Affiliations

¹ IVI Foundation-Instituto de Investigación Sanitaria La Fe (IIS La Fe), Av. Fernando Abril Martorell, 106, Torre A, 46026 Valencia, Spain.
² IVF Laboratory, IVIRMA Roma, Via Federico Calabresi, 11, 00169 Rome, Italy.
³ Andrology Laboratory and Sperm Bank, IVIRMA Valencia, Plaza de la Policia Local 3, 46015 Valencia, Spain.

Abstract

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 (n = 204), 31-40 (n = 5752), and >40 years (n = 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; p = 0.012) and AOR 0.61 (95% CI, 0.41-0.91; p = 0.017), respectively] and longer pregnancies [ARC 5.09 (95% CI, 2.39-7.79; p < 0.001) and ARC 4.54 (95% CI, 1.51-7.58; p = 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; p = 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.

Keywords: assisted reproductive technology (ART); donated oocytes; obstetrical outcomes; offspring’s health; paternal age; perinatal outcomes; pregnancy.

Grants and funding

A.N.-G. is supported by the Spanish Ministry of Science, Innovation, and Universities (FPU19/06126). M.G.J. is supported by the Instituto de Salud Carlos III (FI19/00051 2019/0172).