Abstract
This retrospective cohort study aimed to explore whether paternal age and semen quality parameters affect the embryological and clinical outcomes of ICSI with oocyte donation. A total of 339 oocyte donation (OD)-ICSI cycles were categorized into four groups according to the semen parameter profiles of the male counterparts: normozoospermia (NS, n = 184), oligozoospermia (OS, n = 41), asthenozoospermia (AS, n = 50), and oligoasthenozoospermia (OAS, n = 64). The effect of age, total sperm count, and progressive motility was separately analyzed for reproductive outcomes and compared between the study groups: fertilization, blastulation, and top-quality embryo rate, biochemical and clinical pregnancy, live birth, and miscarriage. A negative correlation between male age and fertilization rate was observed (rs = − 0.23, p < 0.0001), while male age was a significant factor for biochemical pregnancy (p = 0.0002), clinical pregnancy (p = 0.0017), and live birth (p = 0.0038). Reduced total sperm count and lowered progressive motility led to poorer fertilization rates (rs = 0.19 and 0.35, respectively, p < 0.0001) and affected embryo quality (rs = 0.13, p = 0.02, and rs = 0.22, p < 0.0001, respectively). OD-ICSI cycles with asthenozoospermia had significantly lowered success rates in biochemical pregnancy, clinical pregnancy, and live birth (p < 0.05). Our study demonstrated that both advanced male age and reduced progressive motility of spermatozoa exert a significant negative influence on the outcome of assisted reproduction, even in controlled procedures with gamete selection and optimization such as in OD-ICSI. Improvement in treatment strategies and male fertility evaluation requires incorporation of such evidence to obtain better prognosis towards personalized management.
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Acknowledgements
We owe a heartfelt thanks to Associate Professor Mara Simopoulou for discussing important scientific context and for her supportive advice and to the Medical and Paramedical staff of the Assisted Reproduction Unit “IVF Athens” for their valuable support and contribution in the successful conduction of all the included ART cycles.
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Paraskevi Vogiatzi conceived the study. The study was designed by Paraskevi Vogiatzi, Abraham Pouliakis, Maria Sakellariou, Aikaterini Athanasiou, and Adamantios Athanasiou. Data collection and analysis were performed by Paraskevi Vogiatzi, Abraham Pouliakis, Maria Sakellariou, Aikaterini Athanasiou, and Adamantios Athanasiou. The first draft of the manuscript was written by all authors, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The study was approved by the Research and Ethics Committee of the Reproductive Center (EVD 0701/2020) and has been conducted in accordance with the ethical standards of the National Authority for Medically Assisted Reproduction and with the 1964 Helsinki Declaration and its later amendments.
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Throughout the study and especially during data acquisition and analysis, anonymity was strictly preserved by an initial assignment of an exclusive code for each participant, with no other identifying characteristics recorded. Patients received extensive consultation on the procedures to be followed, and written consent was obtained by all participants on treatment.
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Not applicable, no identifying information about participants is contained on the manuscript or in data collection and analysis performed.
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Vogiatzi, P., Pouliakis, A., Sakellariou, M. et al. Male Age and Progressive Sperm Motility Are Critical Factors Affecting Embryological and Clinical Outcomes in Oocyte Donor ICSI Cycles. Reprod. Sci. 29, 883–895 (2022). https://doi.org/10.1007/s43032-021-00801-1
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DOI: https://doi.org/10.1007/s43032-021-00801-1