Combined advanced parental age has an additive negative effect on live birth rates—data from 4057 first IVF/ICSI cycles
The purpose of this study is to determine if there is an additive effect of combined advanced maternal and paternal age on pregnancy and live birth rates.
Retrospective data analysis of 4057 first cycles at a fertility centre between 2009 and 2013 was compiled. Donor, preimplantation genetic screening and double embryo transfer cycles were excluded. Main outcomes measured were clinical pregnancy, viable pregnancy, live birth and term birth.
Logistic regression indicated strong negative associations for maternal ages exceeding 27 years with clinical pregnancies (p < 0.001), viable pregnancies (p < 0.001), live births (p < 0.001) and term births (p < 0.001). There was evidence of negative associations between paternal age and both viable pregnancies (p = 0.06) and live births (p = 0.04), such that the probability of pregnancy was 10% further reduced for women who were 35 years with a partner over 40 years vs. women aged 35 years with a partner under 30 years. There was evidence of an interaction between maternal age and the paternal age on term births (p = 0.02) such that advanced paternal age’s effect on the probability of a term birth was only evident in couples where the maternal age ranged between ~27 and 35 years.
There is an additive effect to pregnancy and live birth rates when both partners are of an advanced age, thus highlighting the need for pre-conception public health messaging and a combined approach to ART counselling assessing both parental ages in combination.
KeywordsFertility Subfertility Ageing Sperm Oocyte
Michelle Lane is a recipient of an NHMRC Senior Research Fellowship. Nicole McPherson is a recipient of an NHMRC Early Career Fellowship.
Authors’ roles and declaration
ML, NOM, and DZ devised the study. AV analysed the data, NOM interpreted the data, NOM wrote the manuscript and DZ and ML edited and approved the final version. All authors certify that they have seen and approved the final version of the manuscript being submitted. They warrant that the article is the authors’ original work, it has not received prior publication and is not under consideration for publication elsewhere.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest; however, we do disclose that NOM, DZ and ML are all employees of Monash IVF Group.
Institution review board approval to retrospectively analyse this data was obtained from the Repromed Scientific Advisory Board and the University of Adelaide Human Research Ethics Branch as per Australian National Health and Medical Research Council Ethical Guidelines. For this type of study, formal consent is not required.
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