Effect of advanced paternal age on fertility and pregnancy'

Medline ® Abstracts for References 7-11
of 'Effect of advanced paternal age on fertility and pregnancy'


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TI Changes with age in the level and duration of fertility in the menstrual cycle.
AU Dunson DB; Colombo B; Baird DD
SO Hum Reprod 2002 May;17(5):1399-403.

BACKGROUND: Most analyses of age-related changes in fertility cannot separate effects due to reduced frequency of sexual intercourse from effects directly related to ageing. Information on intercourse collected daily through each menstrual cycle provides the data for estimating day-specific probabilities of pregnancy for specific days relative to ovulation, and these estimates allow unconfounded analysis of ageing effects. METHODS: A total of 782 healthy couples using natural family planning methods contributed prospective data on 5860 menstrual cycles. Day of ovulation was based on basal body temperature measurements. Estimates of day-specific probabilities of pregnancy and the length of the fertile window were compared across age groups. RESULTS: Nearly all pregnancies occurred within a 6 day fertile window. There was no evidence for a shorter fertile window in older men or women. On average, the day-specific probabilities of pregnancy declined with age for women from the late 20s onward, with probabilities of pregnancy twice as high for women aged 19-26 years compared with women aged 35-39 years. Controlling for age of the woman, fertility was significantly reduced for men aged>35 years. CONCLUSIONS: Women's fertility begins to decline in the late 20s with substantial decreases by the late 30s. Fertility for men is less affected by age, but shows significant decline by the late 30s.

AD Biostatistics Branch, MD A3-03, National Institute of Environmental Health Sciences, National Institutes of Health, P.O.Box 12233, Research Triangle Park, NC 27709, USA. dunson1@niehs.nih.gov
PMID 11980771

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TI Effect of male age on fertility: evidence for the decline in male fertility with increasing age.
AU Hassan MA; Killick SR
SO Fertil Steril 2003 Jun;79 Suppl 3:1520-7.

OBJECTIVE: To evaluate the effect of men's age on time to pregnancy (TTP) using age at the onset of pregnancy attempts, adjusting for the confounding effects of women's age, coital frequency, and life-style characteristics. DESIGN: Observational study. SETTINGS: Teaching hospital in Hull, United Kingdom. PATIENT(S): Two thousand one hundred twelve consecutive pregnant women. INTERVENTION(S): A questionnaire inquiring about TTP, contraceptive use, pregnancy planning, previous subfertility, previous pregnancies, age, and individual life-style characteristics of both partners. MAIN OUTCOME MEASURE(S): Time to pregnancy, conception rates, and relative risk of subfecundity for men and women's age groups. RESULTS: As with women's age, increasing men's age was associated with significantly rising TTP and declining conception rates. A fivefold increase in TTP occurred with men's age>45 years. Relative to men<25 years old, those>45 years were 4.6-fold and 12.5-fold more likely to have had TTP of>1 or>2 years. Restricting the analysis to partners of young women revealed similar effects of increasing men's age. Women>35 years were 2.2-fold more likely to be subfertile than women<25 years. The results were comparable, whether age at conception or at the onset of pregnancy attempts was analyzed, and they remained unchanged after adjustment for the confounding factors. CONCLUSION(S): Evidence for and quantification of the decline in men's fertility with increasing age is provided.

AD The University of Hull, Post Graduate Medical Institute and Hull&York Medical School, Hull, United Kingdom. manhassan@yahoo.com
PMID 12801554

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9
TI The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer.
AU Klonoff-Cohen HS; Natarajan L
SO Am J Obstet Gynecol 2004 Aug;191(2):507-14.

OBJECTIVE: This study was undertaken to determine effects of male aging on sperm parameters, fertilization, pregnancy, and live birth rates among in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT) couples. The impact of female age was also investigated. STUDY DESIGN: Prospective study was made up of 221 IVF and GIFT couples. RESULTS: Pregnancy rates declined as the male subjects aged. Each additional year of paternal age was associated with 11% increased odds (P=.007) of not achieving a pregnancy, and 12% odds (P=.01) of not having a successful live birth. For first-time IVF/GIFT recipients, each additional year of paternal age was associated with a 5% increased odds of not achieving a pregnancy, whereas for repeaters it was 40% (P=.01). Advancing maternal age was associated with decreased numbers of oocytes retrieved or fertilized. Women 40 years or older compared with younger than 35 years had greater than 4-fold risk of not becoming pregnant, and greater than 20-fold risk of not achieving a live birth. CONCLUSION: Advancing paternal (and maternal) age had a deleterious effect on IVF and GIFT outcomes.

AD Department of Family and Preventive Medicine, University of California, San Diego, CA, USA.
PMID 15343228

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TI Paternal age>or=40 years: an important risk factor for infertility.
AU de La Rochebrochard E; Thonneau P
SO Am J Obstet Gynecol 2003 Oct;189(4):901-5.

OBJECTIVE: The purpose of this study was to examine the risk of infertility that is associated with paternal age, because this factor rarely has been investigated, whereas maternal age of>or=35 years is a well-known risk factor. STUDY DESIGN: This large, retrospective, population-based sample included 6188 European women (from Denmark, Italy, Spain, Germany) aged 25 to 44 years who were selected randomly from census registers in 1991 through 1993. RESULTS: Among couples composed of a woman aged 35 to 39 years, risks were significantly higher when paternal age was>or=40 years than when paternal age was<40 years, with an adjusted odds ratio of 2.21 (95% CI, 1.13, 4.33) for delay in pregnancy onset (failure to conceive within 12 months) and of 3.02 (95% CI, 1.56, 5.85) for difficulties in having a baby (failure to conceive within 12 months or pregnancy not resulting in a live birth). CONCLUSION: Like maternal age of>or=35 years, paternal age of>or=40 years should be considered to be a key risk factor for infertility.

AD Institut National de la Sante et de la Recherche Medicale, Le Kremlin-Bicetre, France.
PMID 14586322

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TI Fathers over 40 and increased failure to conceive: the lessons of in vitro fertilization in France.
AU de La Rochebrochard E; de Mouzon J; Thepot F; Thonneau P
SO Fertil Steril. 2006 May;85(5):1420-4. Epub 2006 Apr 17.

OBJECTIVE: To investigate paternal age effect mediated by biological modifications with use of data from assisted reproductive technologies. DESIGN: National IVF registry. SETTING: Fifty nine French IVF centers. PATIENT(S): A total of 1,938 men whose partners were totally sterile, with bilateral tubal obstruction or absence of both tubes (to avoid bias sampling in analysis of paternal age) and treated by conventional IVF. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Risk of failure to conceive defined as absence of intrauterine pregnancy. RESULT(S): The odds ratio of failure to conceive for paternal age>or =40 years was 2.00 (95% confidence interval [CI]: 1.10-3.61) when the woman was 35-37 years old, 2.03 (95% CI: 1.12-3.68) for age 38-40 years, and 5.74 (95% CI: 2.16, 15.23) for age 41 years and over. CONCLUSION(S): As an increasing number of couples choose to postpone childbearing, they should be informed that paternal age over 40 years is an important risk factor for failure to conceive.

AD INED, Le Kremlin-Bicetre, F-94276, France. roche@ined.fr
PMID 16616749