title: Male age negatively influences clinical pregnancy rate in women younger than 40 years undergoing donor insemination cycles.
abstract: The influence of paternal age on clinical pregnancy was examined within younger patients undergoing donor insemination (DI) cycles in Western Australia. A retrospective analysis of 2142 DI cycles was carried out, including only women <40 years with no history of fertility problems. Logistic regression analysis was used to relate donor age to clinical pregnancy rate. Proportional hazards regression analysis was used to relate male age to time to pregnancy. Mediation analysis was conducted to adjust for influence of sperm concentration and motility. Analysis was controlled for female age, luteal-phase progesterone support and insemination year. There was no effect of female age on pregnancy rate or time to pregnancy. Older males (age ≥ 45 years) were significantly associated with a reduced pregnancy rate and longer time to pregnancy. Mediation analysis indicated that sperm concentration and motility did not fully account for the effect of male age on pregnancy. This study reveals an adverse effect of male age on clinical pregnancy in women <40 years of age that is not solely mediated by decreased sperm concentration or motility. This has implications for recruitment systems that attract older donors such as open-identity systems, which may benefit from actively recruiting younger donors.
authors.affiliation: School of Anatomy, Physiology and Human Biology, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia. su-ann.koh@graduate.uwa.edu.au
authors.forename: Su-Ann
authors.initials: SA
authors.lastname: Koh
authors.forename: Katherine
authors.initials: K
authors.lastname: Sanders
authors.forename: Richard
authors.initials: R
authors.lastname: Deakin
authors.forename: Peter
authors.initials: P
authors.lastname: Burton
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007316:Insemination, Artificial, Heterologous; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D010331:Paternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055101:Semen Analysis; D014019:Tissue Donors; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
keywords: donor insemination; male age; pregnancy; sperm concentration; sperm donors; sperm motility