İn Vitro Fertilizasyon/İntrasitoplazmik Sperm Enjeksiyonu Uygulanan Çiftlerde Paternal Yaşın Düşük Oranlarına Etkisi

Amaç: Bu çalışmanın amacı in vitro fertilizasyon/intrasitoplazmik sperm enjeksiyonu tedavi siklusları uygulanan çiftlerde paternal yaşın düşük oranları üzerindeki etkisini belirlemektir. Gereç ve Yöntemler: Hastalar iki gruba ayrıldı. Gebeliği düşükle sonuçlanan hastalar (n=73) çalışma grubunu ve canlı tekil doğum yapan hastalar (n=256) ise kontrol grubunu oluşturdu. Demografik özellikler, tedavi endikasyonları, infertilite süresi, adetin 3. günü folikül uyarıcı hormon, östradiol, lüteinize edici hormon, toplam antral folikül sayısı, anti-Müllerian hormon seviyeleri ve kontrollü ovaryan stimülasyon parametreleri, tetikleme günü, tetikleme gününde östradiol ve progesteron seviyeleri, toplanan toplam oosit sayısı, matur oosit sayısı, embriyo sayısı ve kalitesi, tetikleme, oosit pick-up ve embriyo transfer gününde endometrial kalınlık, embriyo-fundus mesafesi ve embriyo transfer günü kaydedildi. Bulgular: Bu çalışmaya toplam 329 kadın dahil edildi. Açıklanamayan infertilite tanısı alan hasta sayısı çalışma grubunda kontrol grubuna göre istatistiksel olarak anlamlı derecede daha yüksek idi (p=0,020). Anne yaşının, çalışma grubunda kontrol grubuna göre istatistiksel olarak anlamlı derecede daha yüksek olduğu bulundu (p=0,025). Anne yaşı 1 birim arttığında, düşük yapma riskinin de %8,7 oranında arttığı ve açıklanamayan infertilitesi olanların açıklanamayan infertilitesi olmayanlara göre ise %75,6 oranında daha yüksek oranda düşük yapma riskine sahip olduğu görüldü. Sonuç: Paternal yaş düşük yapma ile ilişkili olarak bulunmazken, anne yaşı ve açıklanamayan infertilite ile düşük oranı arasında pozitif bir korelasyon olduğu görüldü.

Anahtar Kelimeler:

Paternal yaş, düşük oranı, açıklanamayan infertilite, anne yaşı, IVF/ICSI

Effect of Paternal Age on Miscarriage Rates in Couples Undergoing In Vitro Fertilization/Intracytoplasmic Sperm Injection

Aim: The aim of this study was to determine the effect of paternal age on miscarriage rates in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment cycles. Material and Methods: Patients were classified into two groups. The study group consisted of the patients whose pregnancy resulted in a miscarriage (n=73) and a control group in which the patients had a live singleton birth (n=256). Demographic characteristics, treatment indications, duration of infertility, menstruation day 3 follicle stimulating hormone, estradiol, luteinizing hormone, total antral follicle count, anti-Mullerian hormone levels and controlled ovarian stimulation parameters, day of trigger, estradiol and progesterone levels on the day of trigger, the total number of oocytes retrieved, the number of mature oocytes, the number and quality of the embryo, endometrial thickness on the day of trigger, oocyte pick up and embryo transfer, the distance of embryo-fundus and the day of embryo transfer were recorded. Results: Totally 329 women were included in the present study. The number of patients with the diagnosis of unexplained infertility was statistically significantly higher in the study group than in the control group (p=0.020). Maternal age was found statistically significantly higher in the study group than in the control group (p=0.025). When maternal age increased by 1 unit, the risk of miscarriage increased by 8.7% and those with unexplained infertility had a 75.6% higher risk of miscarriage than those without unexplained infertility. Conclusion: Paternal age was not associated with miscarriage whereas maternal age and unexplained infertility had a positive correlation with miscarriage rate.

Keywords:

Paternal age, miscarriage rate, unexplained infertility, maternal age, IVF/ICSI,

PDF

___

O'Brien Y, Wingfield MB. Reproductive ageing-turning back the clock? Ir J Med Sci. 2019;188(1):161-7.
Frick AP. Advanced maternal age and adverse pregnancy outcomes. Best Pract Res Clin Obstet Gynaecol. 2021;70:92-100.
Huang Y, Li J, Zhang F, Liu Y, Xu G, Guo J, et al. Factors affecting the live-birth rate in women with diminished ovarian reserve undergoing IVF-ET. Arch Gynecol Obstet. 2018;298(5):1017-27.
Frederiksen LE, Ernst A, Brix N, Braskhøj Lauridsen LL, Roos L, Ramlau-Hansen CH, et al. Risk of adverse pregnancy outcomes at advanced maternal age. Obstet Gynecol. 2018;131(3):457-63.
Vogiatzi P, Pouliakis A, Sakellariou M, Athanasiou A, Athanasiou A, Colaghis A, et al. Male age and progressive sperm motility are critical factors affecting embryological and clinical outcomes in oocyte donor ICSI cycles. Reprod Sci. 2022;29(3):883-95.
Kaarouch I, Bouamoud N, Madkour A, Louanjli N, Saadani B, Assou S, et al. Paternal age: Negative impact on sperm genome decays and IVF outcomes after 40 years. Mol Reprod Dev. 2018;85(3):271-80.
Lu XM, Liu YB, Zhang DD, Cao X, Zhang TC, Liu M, et al. Effect of advanced paternal age on reproductive outcomes in IVF cycles of non-male-factor infertility: a retrospective cohort study. Asian J Androl. 2022;[Epub ahead of print]. doi: 10.4103/aja202234.
Cito G, Coccia ME, Picone R, Cocci A, Russo GI, Garaffa G, et al. Impact of advanced paternal age on the intracytoplasmic sperm injection (ICSI) outcomes in donor egg cycles. Transl Androl Urol. 2019;8(Suppl 1):S22-S30.
Elbardisi H, Arafa M, Singh N, Betts B, Agrawal A, Henkel R, et al. The effect of paternal age on intracytoplasmic sperm injection outcome in unexplained infertility. Arab J Urol. 2021;19(3):274-80.
Murugesu S, Kasaven LS, Petrie A, Vaseekaran A, Jones BP, Bracewell-Milnes T, et al. Does advanced paternal age affect outcomes following assisted reproductive technology? A systematic review and meta-analysis. Reprod Biomed Online. 2022;45(2):283-331.
Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270-83.
Carbone L, Cariati F, Sarno L, Conforti A, Bagnulo F, Strina I, et al. Non-invasive prenatal testing: current perspectives and future challenges. Genes (Basel). 2020;12(1):15.
Vagnini L, Baruffi RL, Mauri AL, Petersen CG, Massaro FC, Pontes A, et al. The effects of male age on sperm DNA damage in an infertile population. Reprod Biomed Online. 2007;15(5):514-9.
García-Ferreyra J, Luna D, Villegas L, Romero R, Zavala P, Hilario R, et al. High aneuploidy rates observed in embryos derived from donated oocytes are related to male aging and high percentages of sperm DNA fragmentation. Clin Med Insights Reprod Health. 2015;9:21-7.
Tiegs AW, Sachdev NM, Grifo JA, McCulloh DH, Licciardi F. Paternal age is not associated with pregnancy outcomes after single thawed euploid blastocyst transfer. Reprod Sci. 2017;24(9):1319-24.
Borges E Jr, Zanetti BF, Setti AS, Braga DPAF, Provenza RR, Iaconelli A Jr. Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertil Steril. 2019;112(3):483-90.
du Fossé NA, van der Hoorn MP, van Lith JMM, le Cessie S, Lashley EELO. Advanced paternal age is associated with an increased risk of spontaneous miscarriage: a systematic review and meta-analysis. Hum Reprod Update. 2020;26(5):650-69.
Morris G, Mavrelos D, Odia R, Viñals Gonzalez X, Cawood S, Yasmin E, et al. Paternal age over 50 years decreases assisted reproductive technology (ART) success: A single UK center retrospective analysis. Acta Obstet Gynecol Scand. 2021;100(10):1858-67.
Luna M, Finkler E, Barritt J, Bar-Chama N, Sandler B, Copperman AB, et al. Paternal age and assisted reproductive technology outcome in ovum recipients. Fertil Steril. 2009;92(5):1772-5.
Gu L, Zhang H, Yin L, Bu Z, Zhu G. Effect of male age on the outcome of in vitro fertilization: oocyte donation as a model. J Assist Reprod Genet. 2012;29(4):331-4.
Stone BA, Alex A, Werlin LB, Marrs RP. Age thresholds for changes in semen parameters in men. Fertil Steril. 2013;100(4):952-8.
Mikwar M, MacFarlane AJ, Marchetti F. Mechanisms of oocyte aneuploidy associated with advanced maternal age. Mutat Res Rev Mutat Res. 2020;785:108320.
Wang X, Lin Y, Liu Z, Huang X, Chen R, Huang H. Analysis of the causes and influencing factors of fetal loss in advanced maternal age: a nested case-control study. BMC Pregnancy Childbirth. 2021;21(1):538.
Smith S, Pfeifer SM, Collins JA. Diagnosis and management of female infertility. JAMA. 2003;290(13):1767-70.
Fuchinoue K, Fukui A, Chiba H, Kamoi M, Funamizu A, Taima A, et al. Expression of retinoid-related orphan receptor (ROR)γt on NK22 cells in the peripheral blood and uterine endometrium of women with unexplained recurrent pregnancy loss and unexplained infertility. J Obstet Gynaecol Res. 2016;42(11):1541-52.
Ran Y, He J, Chen R, Qin Y, Liu Z, Zhou Y, et al. Investigation and validation of molecular characteristics of endometrium in recurrent miscarriage and unexplained infertility from a transcriptomic perspective. Int J Med Sci. 2022;19(3):546-62.