P-086 Impact of male age on IVF/ICSI treatments: is there a place for male social spermatozoa freezing?

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Abstract Study question Does advanced male age impact IVF/ICSI treatment outcomes when a female partner’s age is factored in? Summary answer In IVF/ICSI cycles with fresh embryo transfer, there was no effect of advanced male age on pregnancy and livebirth rates irrespective of female partner age. What is known already The average male age at first pregnancy has risen significantly over the last decade owing to various factors, including longer life expectancy and later marriage. Semen quality declines with increasing age; however, there is conflicting evidence regarding the impact of male age on IVF/ICSI outcomes. Some studies have shown that paternal age increases the miscarriage rate and reduces live birth rate, while others report no effect. There is no single accepted definition of advanced male age, and the cutoff at which there is a significant deleterious effect on outcomes is still unknown. Study design, size, duration A retrospective analysis of autologous IVF/ICSI cycles with fresh embryo transfer from a tertiary center was performed. A total of 811 cycles (382 IVF and 429 ICSI) between March 2013 and May 2024 were included. Exclusion criteria included treatment cycles with endometriosis or ovulatory disorders, cycles that used donor oocyte-donor sperm, frozen sperm, and cycles with freeze all. Female age was under 40 years old. Participants/materials, setting, methods The sample was subgrouped according to male age as < 35-year-old(reference group), 35-39-year-old or ≥ 40-year-old. Women were stratified into <35 or 35-39-year-old. Female median age was 36-year-old(IQR 33-39) and male median age was 38-year-old(IQR 34-41). Primary outcome was clinical pregnancy rate, and secondary outcomes were fertilization rate, embryo quality, live birth and miscarriage rates. Multivariate logistic regression analysis with clinical pregnancy rate as the dependent variable and maternal and paternal age as independent variables was performed. Main results and the role of chance Clinical pregnancy rate was not significantly different in the 35-39-year-old male group (27.3%; P > 0.05) but was significantly higher in the ≥40-year-old male group (34.1%; P = 0.02) than in the reference group <35-year-old group (20.9%), when female age was 35-39 years. No effect of male age was verified for female age group < 35-years-old. After adjusting for confounders including female age, number of previous treatment cycles, smoking, insemination method (IVF or ICSI), number, quality and developmental stage of embryos transferred, duration and cause of infertility and markers of ovarian reserve (antimullerian hormone and antral follicle count) male age did not remain significantly associated with pregnancy rate in the female age-group of 35-39 years (OR 1.03, 95%CI 1.00-1.07, P = 0.08). The live birth rate (12.8%, 15.1%, and 15.9%) 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). The miscarriage rates (4.7%, 5.0%, and 8.6%) were 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 an increasing trend. The results suggest that fertilization and high-quality embryo rates were not significantly different across the paternal age subgroups (all P > 0.05). Limitations, reasons for caution Considering the retrospective design of our study, our results should not be interpreted as a justification for postponing parenthood. Advanced paternal age has been associated with genetic abnormalities, such as chromosomal aneuploidies, as well as with offspring’s diseases, including autism and bipolar disorders, and these outcomes could not be evaluated. Wider implications of the findings Women’s age-related fertility decline and ineffective fertility treatments at older ages justify the planned oocyte cryopreservation. The effect of advanced paternal age on reproduction remains controversial; therefore, there is no clear indication for social cryopreservation of spermatozoa as a strategy against age-related infertility. Trial registration number No