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

Capsule:
Paternal age does not seem to exert a statistically significant influence on oocyte donation outcomes.

Authors:
Lena Sagi-Dain, M.D., Shlomi Sagi, M.D., Martha Dirnfeld, M.D.

Volume 104, Issue 4, Pages 857-865

Abstract:

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.

  • Thorough review. Reassuring that higher paternal age sperm can still have excellent outcomes in donor situations. However, the neuro-psychiatric disorders that are seen with advanced paternal age cannot be ignored as discussed in the paper. Thorough counseling is necessary for the couple undergoing donor oocyte using sperm with advanced paternal age.

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