Paternal age predicts live birth in women above 40 years of age undergoing in-vitro fertilization (IVF)

Abstract

Paternal age predicts live birth in women above 40 years of age undergoing in-vitro fertilization (IVF) Guy Shrem1,2 , Nouf M. Alasmari2 , Jacques Balayla1 , Alexander Volodarsky-Perel1,2 , Weon-Young Son2 , Michael H. Dahan1,2, * 1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada 2MUHC Reproductive Center, McGill University, 888 Boul de Maisonneuve E #200, Montréal, QC H2L 4S8, Canada *Correspondence: dahanhaim@hotmail.com (Michael H. Dahan) DOI:10.31083/j.ceog.2021.02.2275 This is an open access article under the CC BY-NC 4.0 license (https://creativecommons.org/licenses/by-nc/4.0/). Submitted: 28 August 2020 Revised: 21 October 2020 Accepted: 20 November 2020 Published: 15 April 2021 Purpose: To determine which factors predict pregnancy outcome in women aged 40 years and above who underwent in-vitro fertilization. Method: We conducted a retrospective case-control study of 631 women aged 40--46 years, who underwent a total of 904 IVF cycles with autologous gametes. We used stepwise logistic regression analysis to develop predictors of pregnancy, clinical pregnancy and live birth outcomes. Data are presented as mean ± SD, percentage and confidence intervals. Results: Predictors of live birth included maternal (95% CI: 0.36--0.78) and paternal (95% CI: 0.62--0.94) age, the number of follicels>14 mm (95% CI: 1.2--3.2), the number of oocytes collected (95% CI: 1.3--2.9) the number of metaphase II oocytes (95% CI: 1.3--2.4) and the number of cleavage stage embryos (95% CI: 1.8-- 2.6). The predictors of pregnancy and clinical pregnancy were similar but did not include male age (P > 0.05). To further determine the role of male age in live birth a control group of women younger than 40 years was collected. Male age was not a significant predictor of live birth among younger women (P = 0.42). Conclusions: Female age and better ovarian stimulation were confirmed as predictors of outcomes in older women doing IVF. However, male age was also noted to be a significant individual predictor of live birth in women over 40 years of age, but not in younger women doing IVF. Keywords Advanced maternal age; Advanced paternal age; Biologic clock; IVF; In-vitro fertilization