Effect of paternal age on reproductive outcomes in oocyte donation model: a systematic review

Objective: To perform a meta-analysis of the literature examining the influence of paternal age on oocyte donation outcomes. Design: Systematic review of the literature with no language or time restrictions. Setting: Not applicable. Patient(s): None. Intervention(s): None. Main Outcome Measure(s): Pregnancy and live-birth rates. Result(s): By independent screening of titles and abstracts, two investigators selected original studies examining the influence of paternal age on oocyte donation outcomes. Twelve articles were included, encompassing a total of 12,538 oocyte-donation cases. No statistically significant correlation was found by most studies between advanced paternal age and the rate of fertilization, cleavage embryo development, implantation, pregnancy, miscarriage, or live birth. A statistically significant decrease in blastocyst embryo formation was suggested in two articles. Except for volume and possibly motility, other sperm characteristics such as concentration and morphology did not alter with age. However, the overall quality of the evidence was rated as very low according to Grading of Recommendations Assessment, Development, and Evaluation criteria. Conclusion(s): The available evidence suggests that advancing paternal age is not associated with adverse oocyte donation outcomes, including pregnancy and live-birth rates. However, the suboptimal quality of the available evidence necessitates high-quality, well-adjusted prospective trials that are also aimed at evaluating additional outcomes such as congenital anomalies and various specific long-term disorders. (C) 2015 by American Society for Reproductive Medicine.