INFLUENCE OF PATERNAL AGE ON ASSISTED REPRODUCTIVE TECHNOLOGY CYCLE AND PERINATAL OUTCOMES

Objective To characterize paternal age among assisted reproductive technology (ART) cycles performed in the United States and to evaluate the influence of paternal age on ART cycles and perinatal outcomes. Design Retrospective cohort. Setting Not applicable. Patient(s) All reported fresh, nondonor, noncancelled in vitro fertilization (IVF) cycles performed in 2017. Intervention(s) Not applicable. Main Outcome Measure(s) The primary outcomes were intrauterine pregnancy, live birth (≥20 weeks), and miscarriage ( Result(s) Among 77,209 fresh nondonor, noncancelled IVF cycles, the average paternal age was 37.8 ± 6.3 years and the average maternal age was 35.5 ± 4.6 years. Compared with paternal age ≤45 years, paternal age ≥46 years was associated with a lower likelihood of pregnancy per cycle (adjusted risk ratio [aRR] 0.81; 95% confidence interval [CI] 0.76–0.87) and per transfer (aRR 0.85; 95% CI 0.81–0.90), as well as a lower likelihood of live birth per cycle (aRR 0.76; 95% CI 0.72–0.84) and per transfer (aRR 0.82; 95% CI 0.77–0.88) after controlling for maternal age and other confounders. When restricted to women aged Conclusion(s) Compared with paternal age ≤45 years, paternal age ≥46 years is associated with a lower likelihood of pregnancy and live birth among couples undergoing IVF. The negative effect of paternal age is most notable among women aged ≥35 years, likely because maternal age is a stronger predictor of ART outcome.