The Effects of Increased Male Age in IVF and Egg Donation
K.C. Humm, D. Sakkas
K.C. Humm, D. Sakkas
It’s no secret that both males and females are deciding to conceive a little later in life these days. It’s also no secret that the increase in age in women has made it particularly difficult when it comes time to conceive. The question here is what the risks may be for the offspring of males deciding to have children when they are a bit older. Kathryn C. Humm M.D., and Denny Sakkas, Ph.D. examine the association between male age and outcomes based on treatment modality, including intrauterine insemination (IUI), IVF, and donor oocyte IVF. They also discuss various mechanisms by which male age may impact sperm and fertility potential including sperm DNA damage.
In this review, Humm and Sakkas’ bring to light the risks to the offspring of advancing male age and review data available regarding pregnancy outcomes based on paternal age in both fertile and infertile populations.
Comparing offspring of males aged 25-29, the offspring of a male less than 50 years old is 7.8 times more likely to be diagnosed with rare genetic disorders such as achondroplasia and 9.5 times more likely to be diagnosed with Apert syndrome. Sticking with men aged 50 or younger, their offspring are 2.98 times more likely to be diagnosed with schizophrenia as compared to the offspring of men 20-24 years. Based on a cohort study including 132,271 individuals, the authors noted that there was a significant associated between advancing paternal age and the risk of autism spectrum disorders all around.
Despite this growing evidence that advancing paternal age may put offspring at risk of rare autosomal dominant disorders, according to this review, there are no screening or diagnostic tests specifically targeting these conditions that may increase with paternal age.
The small amount of studies suggesting male age play a role in the success of IUI, most focus on the importance of maternal age, semen characteristics, and the number of mature follicles. A published analysis looks at 901 cycles of IUI in 274 couples and a multivariate analysis revealed that male age less than 35 was associated with decreased rates of conception. The authors of a similar French study reports a pregnancy rate of 12.3% per cycle for men older than 30 years versus 9.3% per cycle for men less than 45 years.
Further, Humm and Sakkas gathered information from studies examining the role of paternal age on outcomes in couples undergoing IVF. A study of 221 couples undergoing conventional IVF reports that pregnancy rates decline with advancing male age. The authors reported a 38% live birth rate for men older than 35 years, 17% for men 36-40 years, and only 7% for men less than 40 years old. Each additional year of paternal age tacked on was associated with a 12% increased odds of not successfully having a life birth.
Because of the growing population of patients seeking infertility care continue to age, we should be prepared to discuss the potential risks of advancing paternal age in addition to those of advanced maternal age. However it’s important to note that fertility is much more complicated than just maternal and paternal age.