体外受精-胚胎移植中男性年龄对胚胎质量及妊娠结局的影响

Effect of paternal age on the embryo quality and pregnancy outcomes of in vitro fertilization and embryo transfer

目的:探索在体外受精-胚胎移植中,男性年龄对胚胎质量及妊娠结局的影响。方法:回顾性分析我院生殖中心于2014年1月~2019年12月进行IVF助孕的4010个周期,研究了男性年龄与胚胎质量(即正常受精率、异常受精率、优质胚胎率)的相关性,并评估男性年龄(每5岁为一区间)对妊娠结局(HCG阳性率、临床妊娠率及早期流产率)的影响。结果:在校正女方年龄的影响后,显示男性年龄与正常受精率(B=0.01;95%CI:-0.174~0.193;P>0.05)、异常受精率(B=0.021;95%CI:-0.082~0.124;P>0.05)及优质胚胎率(B=0.104;95%CI:-0.124~0.332;P>0.05)之间没有显著的相关性。在校正女方年龄、移植胚胎天数及移植胚胎数量对血HCG阳性率及临床妊娠率的影响后,结果显示男性年龄与血HCG阳性率(P>0.05)及临床妊娠率(P>0.05)均无相关性。但是在校正女方年龄对早期流产率的影响后,男性年龄>40岁其早期流产的发生较男性年龄≤30时有显著的增加(OR:1.95;95%CI:1.147~3.32;P<0.05)。结论:随着男性年龄的增加,早期流产的风险会显著增高,但是男性年龄对胚胎质量及妊娠率无显著影响。

Objective:In this study,we investigated the effect of paternal age on the embryo quality and pregnancy outcomes of in vitro fertilization and embryo transfer(IVF-ET).Method:We performed a retrospective analysis of 4010 IVF cycles at the reproductive center of Sixth Affiliated Hospital of Sun Yat-sen University from January 2014 to December 2019.Effect of paternal age on embryo quality(the rate of normal fertilization,abnormal fertilization,and high-quality embryo)was analyzed by multiple linear regression.Relationship between paternal age and pregnancy outcomes was analyzed by binary logistic regression.Result:After adjusting for female age,no association between paternal age and the following parameters of embryo quality was observed:normal fertilization rate(B=0.01;95%CI:-0.174-0.193;P>0.05),abnormal fertilization rate(B=0.021;95%CI:-0.082-0.124;P>0.05),or high-quality embryo rate(B=0.104;95%CI:-0.124-0.332;P>0.05).Moreover,paternal age(OR for a 5-year interval)had no effect on the rate of HCG positive(P>0.05)or clinical pregnancy(P>0.05).However,paternal age negatively influenced the early pregnancy loss rate.The incidence of early miscarriage in men aged over 40 years was significantly higher than that in men aged less than 30 years(OR:1.95;95%CI:1.147-3.32;P<0.05).Conclusion:Increased paternal age negatively influences the early pregnancy loss rate,but has no effect on embryo quality in couples undergoing IVF cycles.However,more studies which should include more men aged over 40 years with a longer-term follow-up are needed.