夫妇年龄交互作用与IVF/ICSI后累积活产率:一项大型队列研究
Couple age interaction and cumulative live birth rate after IVF/ICSI: a large cohort study
摘要
该回顾性队列纳入2016—2024年单中心22,013个首次自体卵母细胞取卵周期,分析父龄每增加5岁与三次胚胎移植内累积活产率(CLBR)的关联,并检验母龄交互作用。女性<40岁时父龄与CLBR无显著关联;女性≥40岁时父龄增加与CLBR降低相关(aOR 0.78,95%CI 0.75-0.81),交互作用显著,且累积临床妊娠率降低、流产风险升高,但受精率与优质胚胎率未下降;五次移植敏感性分析结果一致。结论提示父龄的不良影响主要见于女方≥40岁的夫妇,咨询时应联合评估夫妇年龄。
原文摘要
RESEARCH QUESTION: Does maternal age modify the association between paternal age and cumulative live birth rate (CLBR) after IVF/intracytoplasmic sperm injection (ICSI)? DESIGN: This retrospective cohort study included 22,013 first oocyte retrieval cycles using autologous oocytes and non-donor spermatozoa at a tertiary reproductive centre between 2016 and 2024. The primary outcome was CLBR within the first three embryo transfer attempts from a single retrieval. Paternal age was analysed per 5-year increase, and interaction with maternal age was tested formally. Multivariable models adjusted for female body mass index, duration of infertility, type of infertility, fertilization method, and major infertility aetiologies. Sensitivity analyses used CLBR within the first five embryo transfer attempts. RESULTS: Among women aged <40 years, paternal age was not associated with CLBR within three embryo transfer attempts [adjusted OR (aOR) per 5-year increase 0.98, 95% CI 0.94-1.02]. Among women aged ≥40 years, increasing paternal age was associated with lower CLBR (aOR 0.78, 95% CI 0.75- 0.81), with a significant paternal age × maternal age interaction (P for interaction < 0.001). In the older maternal age group, increasing paternal age was also associated with a lower cumulative clinical pregnancy rate and higher risk of miscarriage, whereas fertilization rate and high-quality embryo rate did not decline. Results were consistent when CLBR was defined within the first five embryo transfer attempts. CONCLUSIONS: Paternal age was not uniformly associated with CLBR after IVF/ICSI. Its adverse association became clinically evident mainly among couples in which the female partner was aged ≥40 years. These findings support joint consideration of paternal and maternal age when counselling couples about cumulative reproductive prognosis after assisted reproduction.
推荐理由:大样本单中心队列并正式检验夫妇年龄交互,提示女方≥40岁时父龄对累积活产的不良影响,可直接用于临床咨询;但为回顾性设计,机制与实验室指标信息有限。
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所属事件:夫妇年龄交互作用与IVF/ICSI后累积活产率:一项大型队列研究 热度 0.0 · 0 个来源
收录来源(2)
- 11-08 11:43PubMed · 辅助生殖临床
- 11-08 11:44PubMed · 核心期刊