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Assisted Reproduction Safety and Risks

Impact of paternal age on assisted reproductive technology outcomes and offspring health: a systematic review

Gourinat A, Mazeaud C, Hubert J, Eschwege P, Koscinski I

Published September 2023 Andrology, 11(6), 973-986
DOI 10.1111/andr.13385 PMID 36640151

RRM Academy Synopsis

Advanced paternal age linked to lower semen volume and sperm motility

A review of 111 studies found that advanced paternal age is strongly linked to lower semen volume and sperm motility. In children, advanced paternal age was linked with an exponential rise in achondroplasia and Apert syndrome. Autism and schizophrenia rose more moderately. Evidence on pregnancy rates and fetal chromosome errors was more controversial. The review found no association with miscarriage.

Key Findings

  • Advanced paternal age showed a strong correlation with lower semen volume and lower sperm motility, two of the sperm parameters examined.
  • Achondroplasia and Apert syndrome showed an exponentially increased incidence with advanced paternal age, which the authors describe as infant morbidity.
  • The incidence of autism and schizophrenia increased more moderately with advanced paternal age.
  • The impact of paternal age on pregnancy rates and fetal aneuploidy rates was more controversial in the reviewed literature.
  • No association was found between paternal age and spontaneous abortion rates.

Interpretation

The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. They searched PubMed, ScienceDirect, and Web of Science for articles from 1995 through 2021 and analyzed 111. This synopsis rests on the published abstract alone, which gives no effect sizes. The review reports correlations between paternal age and these outcomes, which do not show that age causes them. The authors ask what rationale supports the upper limit of 60 years that most countries advise for men using assisted reproductive technology (ART). They conclude that older parents undergoing ART should have the scientific parameters explained to them.

RRM Context

Restorative reproductive medicine evaluates both partners. The review ties paternal age to semen findings that can be measured and followed. A cause-based approach looks for what lowers fertility, while IVF proceeds without resolving why conception fails.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

The increase in paternal age and the percentage of births after assisted reproductive technologies (ART) may have consequences on offspring and society's position regarding access to ART must be questioned. Most countries recommend limiting ART to men under 60 years. What is the rationale for this threshold?

Objective

This systematic review assesses scientific arguments to establish links between paternal age, male fertility, and offspring health.

Materials and Methods

Using the PRISMA guidelines, this systematic review of the literature analyzed 111 articles selected after screening PubMed, ScienceDirect, and Web of Science for articles published between January 1, 1995 and December 31, 2021.

Results

A strong correlation was highlighted between advanced paternal age and a decrease of some sperm parameters (semen volume and sperm motility) and infant morbidity (exponentially increased incidence of achondroplasia and Apert syndrome, and more moderately increased incidence of autism and schizophrenia). The impact of paternal age on pregnancy and fetal aneuploidy rates is more controversial. No association was found with spontaneous abortion rates.

Discussion and Conclusions

The scientific parameters should be explained to older parents undergoing ART. And for countries that discuss a limit on paternal age for access to ART, the debate requires consideration of social and ethical arguments.

Topics

Related research

Assisted Reproduction › Safety and Risks › Long Term Child Outcomes · Male Fertility › Male Endocrine and Genetic Factors › Testicular Function · Longevity and Reproductive Aging › Age and Fertility › Male Age and Fertility
Annabelle Gourinat, Charles Mazeaud, Jacques Hubert, Pascal Eschwege, Isabelle Koscinski
A Gourinat, Charlie Mazeaud, Chuck Mazeaud, C Mazeaud, J Hubert, P Eschwege, I Koscinski
PMID 36640151 36640151 DOI 10.1111/andr.13385 10.1111/andr.13385 Gourinat et al. 2023, Gourinat 2023

Keywords

ART, advanced paternal age, fertility, sperm donation, urologic disease

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This site is an educational resource and does not provide medical advice. Inclusion of a study does not imply endorsement of its findings. Always consult a qualified healthcare provider for diagnosis and treatment.

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