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Does paternal age affect the live birth rate in donor oocyte cycles? A systematic review and meta-analysis

  • Assisted Reproduction Technologies
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Abstract

Purpose

While delayed parenthood is increasing worldwide, the effect of paternal age on in vitro fertilization (IVF) outcomes remains unclear. The egg donation model appears to be relevant to studying the independent impact of paternal age on clinical outcome, but the available studies are heterogeneous and contradictory. This systematic review and meta-analysis aimed to assess the relationship between paternal age and live birth rate (LBR) in egg donation cycles.

Methods

A systematic search of the literature was conducted in PubMed, Embase, and the Cochrane Library from inception to June 30, 2021. All studies on egg donation cycles where LBR is reported according to male age were included. Study selection, bias assessment, and data extraction were performed by two independent reviewers according to the Cochrane methods.

Results

Eleven studies involving 10,527 egg donation cycles were finally included. The meta-analysis showed a slight but significant and linear decrease in LBR with increasing paternal age (estimate − 0.0055; 95% CI (− 0.0093; − 0.0016), p = 0.006), with low heterogeneity (I2 = 25%). No specific threshold was identified. A similar trend toward decreased clinical pregnancy rate with advancing paternal age was found but did not reach statistical significance (p = 0.07).

Conclusion

This meta-analysis demonstrates that increasing paternal age is associated with a slight but significant and linear decrease in the live birth rate in egg donation cycles, with no apparent threshold effect. Although this requires further confirmation, this information is important for counseling men who are considering delayed childbearing.

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Data Availability

The data that support the findings of this study are available from the corresponding author, TF, upon reasonable request.

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Acknowledgements

We thank the Interuniversity Library of Medicine (BIUM) of Paris for methodological support. We thank Dr. John Frattarelli, Dr. Hakan Duran, and Dr. Amanda Setti for providing us with detailed data on LBR according to paternal age for their studies. We thank Pr. Brian Whitcomb and Dr. Richard Paulson for answering our queries regarding their studies.

Funding

This work was sponsored by an unrestricted grant from Gedeon Richter France. The sponsor participated in the supervision and revision of the manuscript.

Author information

Authors and Affiliations

  1. Service de chirurgie gynécologique et médecine de la reproduction, CHU Bordeaux, Hôpital Pellegrin, 33000, Bordeaux, France

    Emmanuelle Begon

  2. Service de biologie et médecine de la reproduction, CHU de Nantes, CHU Nantes, Nantes Université, 38 Boulevard Jean Monnet, 44093, Nantes, France

    Tiphaine Lefebvre & Thomas Fréour

  3. Gedeon Richter France, 75008, Paris, France

    Elisangela Arbo & Noémie Rousset

  4. Service de biologie et médecine de la reproduction, CHU Brest, Hôpital Morvan, 29200, Brest, France

    Sarah Bouée

  5. Monitoring Force, 78600, Maisons-Laffitte, France

    Bernadette Darné, Solène Languille & Dikra Mellouhi

  6. Clinique Mutualiste La Sagesse, 4 place saint Guénolé, 35 000, Rennes, France

    Frédérique Jaffré

  7. Centre AMP NatiFiv, Biofutur - Inovie Fertilité, 77100, Meaux, France

    Jean-Christophe Pont

  8. Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, F-44000, Nantes, France

    Thomas Fréour

  9. Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain

    Thomas Fréour

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  1. Emmanuelle Begon
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Correspondence to Thomas Fréour.

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Supplementary Information

Supplementary Fig. 1

Risk of bias assessment for the included studies (PNG 16 kb)

Supplementary Fig. 2

Primary outcome after meta-analysis and exclusion of the outlier study (PNG 83 kb)

High Resolution Image (TIFF 46807 kb)

Supplementary Fig. 3

(a) Line chart of a secondary outcome (CPR) for each study available, using raw data, (b) Linear and nonlinear models of a secondary outcome (CPR) after meta-analysis (PNG 156 kb)

High Resolution Image (TIFF 46807 kb)

(PNG 119 kb)

High Resolution Image (TIFF 84375 kb)

Supplementary Fig. 4

Line chart of a secondary outcome (early pregnancy loss) for each study available, using raw data (PNG 115 kb)

High Resolution Image (TIFF 46807 kb)

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(DOCX 15 kb)

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Begon, E., Lefebvre, T., Arbo, E. et al. Does paternal age affect the live birth rate in donor oocyte cycles? A systematic review and meta-analysis. J Assist Reprod Genet 40, 617–626 (2023). https://doi.org/10.1007/s10815-023-02714-1

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