Impact of paternal age on assisted reproductive technology outcomes and offspring health: a systematic review.
Level 2 - randomized trial
Systematic review of predominantly observational and cohort studies assessing etiology and clinical outcomes.
PubMed 36640151 · doi:10.1111/andr.13385
What was done
A systematic review conducted according to PRISMA guidelines searched PubMed, ScienceDirect, and Web of Science for literature published between January 1, 1995, and December 31, 2021. The authors identified and analyzed 111 articles evaluating the relationship between advanced paternal age, semen parameters, assisted reproductive technology (ART) outcomes, and offspring health.
What was found
The abstract presents directional conclusions without providing quantitative effect sizes, odds ratios, or confidence intervals. Advanced paternal age showed a strong correlation with decreased semen volume and sperm motility, an exponentially higher incidence of achondroplasia and Apert syndrome, and a moderately increased risk of autism and schizophrenia in offspring. Evidence regarding effects on clinical pregnancy rates and fetal aneuploidy was inconsistent, while no association was found with spontaneous abortion rates.
Why it matters
It consolidates evidence to guide clinical counseling and policy debates regarding age thresholds for men undergoing assisted reproduction, indicating that offspring morbidity risks are more consistently linked to paternal age than ART pregnancy failure.
Limits
The abstract reports no numeric data or meta-analytic pooling. The underlying primary studies are observational, carrying risks of residual confounding (particularly maternal age). Specific chronological age thresholds defining advanced paternal age were not detailed in the abstract.
Cited by
- supports Paternal age over 50 is associated with an increased population-level risk of offspring autism, de novo autosomal dominant mutations (such as dwarfism), and schizophrenia.