Influence of paternal age on assisted reproductive technology cycles and perinatal outcomes

Objective: To characterize paternal age among assisted reproductive technology (ART) cycles performed in the United States and to evaluate the influence of paternal age on ART cycles and perinatal outcomes. Design: Retrospective cohort. Setting: Not applicable. Patient(s): All reported fresh, nondonor, noncancelled in vitro fertilization (IVF) cycles performed in 2017. Intervention(s): Not applicable. Main Outcome Measure(s): The primary outcomes were intrauterine pregnancy, live birth (>= 20 weeks), and miscarriage (<20 weeks) per cycle start and per embryo transfer. The secondary outcomes were full-term live birth (>= 37 weeks) among singleton and twin gestations. Modified Poisson regression was performed to estimate associations between paternal age and cycle and perinatal outcomes, overall and stratified by maternal age. Result(s): Among 77,209 fresh nondonor, noncancelled IVF cycles, the average paternal age was 37.8 +/- 6.3 years and the average maternal age was 35.5 +/- 4.6 years. Compared with paternal age <= 45 years, paternal age >= 46 years was associated with a lower likelihood of pregnancy per cycle (adjusted risk ratio [aRR] 0.81; 95% confidence interval [CI] 0.76-0.87) and per transfer (aRR 0.85; 95% CI 0.81-0.90), as well as a lower likelihood of live birth per cycle (aRR 0.76; 95% CI 0.72-0.84) and per transfer (aRR 0.82; 95% CI 0.77-0.88) after controlling for maternal age and other confounders. When restricted to women aged <35 years, there were no significant differences in the rates of live birth or miscarriage among couples in which the men were aged <= 45 years compared with those aged >= 46 years. Conclusion(s): Compared with paternal age <= 45 years, paternal age >= 46 years is associated with a lower likelihood of pregnancy and live birth among couples undergoing IVF. The negative effect of paternal age is most notable among women aged >= 35 years, likely because maternal age is a stronger predictor of ART outcome. (C) 2021 by American Society for Reproductive Medicine.

Automated summary

The study found that paternal age has an impact on the likelihood of pregnancy and live birth among couples undergoing assisted reproductive technology, especially in women aged 35 and older. Compared to paternal age under 45, paternal age over 46 is associated with lower success rates in IVF cycles.