Effect of advanced paternal age on reproductive outcomes in IVF cycles of non-male-factor infertility: a retrospective cohort study

Advanced paternal age has been overlooked,and its effect on fertility remains controversial.Previous studies have focused mainly on intracytoplasmic sperm injection(ICSI)cycles in men with oligozoospermia.However,few studies have reported on men with semen parameters within reference ranges.Therefore,we conducted a retrospective cohort study analyzing the reproductive outcomes of couples with non-male-factor infertility undergoing in vitro fertilization(IVF)cycles.In total,381 cycles included were subgrouped according to paternal age(<35-year-old,35–39-year-old,or≥40-year-old),and maternal age was limited to under 35 years.Data on embryo quality and clinical outcomes were analyzed.The results showed that fertilization and high-quality embryo rates were not significantly different(all P>0.05).The pregnancy rate was not significantly different in the 35–39-year-old group(42.0%;P>0.05),but was significantly lower in the≥40-year-old group(26.1%;P<0.05)than that in the<35-year-old group(40.3%).Similarly,the implantation rate significantly decreased in the≥40-year-old group(18.8%)compared with that in the<35-year-old group(31.1%)and 35–39-year-old group(30.0%)(both P<0.05).The live birth rate(30.6%,21.7%,and 19.6%)was not significantly different across the paternal age subgroups(<35-year-old,35–39-year-old,and≥40-year-old,respectively;all P>0.05),but showed a declining trend.The miscarriage rate significantly increased in the 35–39-year-old group(44.8%)compared with that in the<35-year-old group(21.0%;P<0.05).No abnormality in newborn birth weight was found.The results indicated that paternal age over 40 years is a key risk factor that influences the assisted reproductive technology success rate even with good semen parameters,although it has no impact on embryo development.

Effect of Timing and Number of Intrauterine Insemination (IUI) on the Cycle Clinical Outcome

Objective To study the effect of timing and number of intrauterine insemination （IUI） per cycle on the outcome of artificial insemination by husband （AIH）. Methods A total of 195 infertile couples underwent 379 cycles of lUI with husband＇s sperm. They were divided into 4 groups according to the ovulation and the number of IUIs per cycle： single IUI was performed 24 h after hCG injection, including single IUI before ovulation （group A） and single IUI after ovulation （group B）; double IUI was performed 24 h and 48 h after hCG injection, including double IUI before and after ovulation （group C） and double IUI before ovulation （group D）. The relation-ship between IUI pregnancy rate and the factors like processed total motile sperm （PTMS）, timing and number of lUIs per cycle was analyzed. Results When PTMS〈5 × 10^6, only one case in group B got pregnant, while no pregnancy was observed in other groups. When PTMS ≥ 5 × 10^6, pregnancy rates in all group were improved significantly. The pregnancy rate in group B reached 32.22%, which was significantly higher than that in group A （14.12%）, group C （20.00%） and group D （17.39%）, respectively （P〈0.05）. Conclusion IUI treatment is recommended to be performed when PTMS ≥ 5 × 10^6. An ideal pregnancy rate can be achieved by single IUI which is performed 24 h after hCG injection, and double IUI performed without ovulation could not result in significant improvement of cycle pregnancy rate.