O-296 Paternal age does not affect obstetric and perinatal outcomes in IVF or ICSI cycles with autologous oocytes
Authors: Gil Julia M , Navarro Gomez-Lechon A , Hervas I , Mossetti L , Rivera-Egea R , Garrido N 
Published: June 2022

Abstract

Study question
Does paternal age have any effect on obstetric and perinatal outcomes in in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles with autologous oocytes?

Summary answer
Gestational diabetes, delivery type, cranial circumference and preterm birth were significantly different between our age groups, although after adjusted analysis no significant differences were seen.

What is known already
In recent years, there has been an increase of the average male age at which the first child is conceived. Therefore, studies addressing paternal age and reproductive risks are increasing and results are controversial, so there is a need of more research about it, which this study tries to address. Although several studies suggest the threshold to consider paternal age ‘advanced’ at 40 years, this limit is not well established. The assessment of risks concerning the mother and offspring is important and, thus, so is the study of its association with paternal age.

Study design, size, duration
This retrospective observational multicentric cohort study has considered pregnancies and children conceived from IVF-ICSI performed to couples in Spain IVIRMA clinics between January 2008 and March 2020 using patients’ own sperm and autologous oocytes. Paternal age ranged from 18 to 51 years. The study population was categorized in three groups: &lt;30(A, reference), 30-40(B) and &gt;40(C) years. The data available included 14402 patients who had a delivery with a live birth and 16118 singleton newborns.

Participants/materials, setting, methods
We evaluated pregnancies and children from autologous IVF-ICSI with own semen, known age and resulting in delivery. Data was exported to obtain the clinical database followed by the statistical analysis of the study main outcomes. P &lt; 0.05 was considered statistically significant. Obstetric and perinatal outcomes were measured including delivery type, incidence of preterm birth, gestational diabetes, anemia, hypertension and pre-eclampsia; and newborn sex, weight, length, cranial circumference, Apgar score and neonatal intensive care unit (NICU) admission.

Main results and the role of chance
Results are expressed as rate or mean with 95%CI.
There were no statistically significant differences for the incidence of anemia, hypertension or pre-eclampsia; newborn sex, weight, length, Apgar score (1, 5 and 10 min) and NICU admission between the reference younger group (A) vs. the older paternal age groups (B and C).
However, there were statistically significant differences for the incidence of gestational diabetes when comparing A 5.1%(3.5-7.2) with B 7.7%(7.1-8.3) with OR = 1.5(1.1-2.2)(p = 0.021) and with C 9.1%(7.1-11.4) with OR = 1.9(1.2-2.9)(p = 0.005); for delivery type when comparing A[cesarean 33.8%(31.3-36.4)] with B[cesarean 37.8%(37.0-38.7)] with OR = 1.2(1.1-1.3) (p = 0.004) and with C[cesarean 49.3%(46.7-52.0)] with OR = 1.9(1.6-2.2) (p &lt; 0.001); for cranial circumference when comparing A 34.5(34.3-34.7) with C 34.8(34.6-35.0) with p = 0.03; and for the incidence of preterm birth when comparing A 7.9%(6.6-9.5) with C 5.9%(4.7-7.2) with OR = 0.7(0.5-1.0)(p = 0.034).
These results suggest an increased risk of gestational diabetes and cesarean delivery as paternal age increases. Moreover, group C showed a larger cranial perimeter and a lower risk of preterm birth when compared to group A.
However, after adjusted analysis (according to selected patients’, cycles’ and semen samples’ characteristics, gestational age, newborn sex and type of delivery) these differences were no longer statistically significant, so probably other clinical variables are involved in the differences seen.

Limitations, reasons for caution
Despite the retrospective nature of this study that leads to biases derived from the clinical practice and to the presence of missing data limiting sample size, the study includes a huge sample size.

Wider implications of the findings
Currently, fatherhood delay has led to a growing interest in studies addressing paternal age and reproductive risks. Our paternal age comparison showed significant differences for gestational diabetes, delivery type, cranial circumference and preterm, no longer significant after adjusted analysis, so probably other clinical variables were involved. Further studies are needed.

Trial registration number
Not applicable