Paternal age and assisted reproductive technology: problem solver or trouble maker?

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

  • Mariana Bertoncelli Tanaka, Univ Campinas UNICAMP, Universidade Estadual de Campinas, Dept Surg, Div Urol
  • ,
  • Ashok Agarwal, Cleveland Clin, Cleveland Clinic Foundation, Dept Urol, Amer Ctr Reprod Med
  • ,
  • Sandro C. Esteves, Univ Campinas UNICAMP, Universidade Estadual de Campinas, Dept Surg, Div Urol, ANDROFERT, Androl & Human Reprod Clin

In our society, the number of couples with advanced reproductive age seeking fertility treatment is increasing steadily. While the negative effect of female age on assisted reproductive technology (ART) outcomes is well established, the impact of paternal age needs to be clarified. We reviewed the current literature to determine whether advanced paternal age affects the results of ART and the health of resulting offspring. We found that the published literature is overall supportive of a positive association between advanced paternal age (>40 years) and semen quality deterioration. However, the existing evidence does not corroborate nor discard the influence of advanced paternal age on ART outcomes. Similarly, the effect of paternal age on the health of ART offspring remains equivocal, although data from naturally-conceived children clearly indicates that advanced paternal age increases the frequency of genetic, neurodevelopmental, and psychiatric diseases in the progeny. Noteworthy, the current literature is limited and subjected to bias due to the impact of maternal age as a critical confounder. Health care providers should discuss with concerned couples the available options to counteract the possible negative influence of advanced paternal age on ART outcomes and health of resulting offspring. These include identification and treatment of underlying conditions with potential negative long-term effects on fertility, sperm freezing at a young age, and use of antioxidant supplements for men at risk of excessive oxidative stress. Aged male partner from couples undergoing ART, in particular men of 50 years and older, should consider use of preimplantation genetic testing as a means to detect embryo abnormalities and select euploid embryos for transfer to the uterine cavity.

OriginalsprogEngelsk
TidsskriftPanminerva medica
Vol/bind61
Nummer2
Sider (fra-til)138-151
Antal sider14
ISSN0031-0808
DOI
StatusUdgivet - jun. 2019

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