1
|
Castellini C, Cordeschi G, Tienforti D, Barbonetti A. Relationship between male aging and semen quality: a retrospective study on over 2500 men. Arch Gynecol Obstet 2024; 309:2843-2852. [PMID: 38551703 PMCID: PMC11147833 DOI: 10.1007/s00404-024-07448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/25/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE We aimed to evaluate whether and to what extent an association exists between male aging and worsening of semen parameters and to determine whether a threshold age can be identified above which the decline in semen quality becomes statistically significant. METHODS 2612 men (age: 16-56 years) attending an andrology outpatient clinic for semen analysis and clinical evaluation were studied. Semen analyses were performed according to the ongoing WHO-recommended procedures. Total motile count (TMC) and total progressive motile count (TPMC) were calculated by multiplying total sperm number by total motility and progressive motility, respectively. RESULTS Significant negative correlations were found between age and total motility (r = - 0.131, p < 0.0001), progressive motility (r = - 0.112, p < 0.0001), TPMC (r = - 0.042, p = 0.037), and normal sperm morphology (r = - 0.053, p = 0.007). All these associations persisted in multivariate regression models adjusted for abstinence time, smoking, history of male accessory gland infections, varicocele and the year in which semen analysis was performed. When comparisons were performed among quartiles of increasing age, the fourth quartile, corresponding to the age group > 40 years, was associated with a significant decrease in total and progressive motility. An earlier decline in the TPMC and percentage of normal forms was also observed. CONCLUSION Advancing male age exhibits an independent association with a decrease in the percentage of motile and morphologically normal spermatozoa, with greater evidence from the age of > 40 years. Further studies are warranted to elucidate the mechanisms and clinical reflections of these associations.
Collapse
Affiliation(s)
- Chiara Castellini
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, 67100, L'Aquila, Italy
| | - Giuliana Cordeschi
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, 67100, L'Aquila, Italy
| | - Daniele Tienforti
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, 67100, L'Aquila, Italy
| | - Arcangelo Barbonetti
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, 67100, L'Aquila, Italy.
| |
Collapse
|
2
|
Kaltsas A, Zikopoulos A, Vrachnis D, Skentou C, Symeonidis EN, Dimitriadis F, Stavros S, Chrisofos M, Sofikitis N, Vrachnis N, Zachariou A. Advanced Paternal Age in Focus: Unraveling Its Influence on Assisted Reproductive Technology Outcomes. J Clin Med 2024; 13:2731. [PMID: 38792276 PMCID: PMC11122544 DOI: 10.3390/jcm13102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/28/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
As global demographics shift toward increasing paternal age, the realm of assisted reproductive technologies (ARTs), particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), faces new challenges and opportunities. This study provides a comprehensive exploration of the implications of advanced paternal age on ART outcomes. Background research highlights the social, cultural, and economic factors driving men toward later fatherhood, with a focus on the impact of delayed paternity on reproductive outcomes. Methods involve a thorough review of existing literature, centering on changes in testicular function, semen quality, and genetic and epigenetic shifts associated with advancing age. Study results point to intricate associations between the father's age and ART outcomes, with older age being linked to diminished semen quality, potential genetic risks, and varied impacts on embryo quality, implantation rates, and birth outcomes. The conclusions drawn from the current study suggest that while advanced paternal age presents certain risks and challenges, understanding and mitigating these through strategies such as sperm cryopreservation, lifestyle modifications, and preimplantation genetic testing can optimize ART outcomes. Future research directions are identified to further comprehend the epigenetic mechanisms and long-term effects of the older father on offspring health. This study underscores the need for a comprehensive approach in navigating the intricacies of delayed fatherhood within the context of ART, aiming for the best possible outcomes for couples and their children.
Collapse
Affiliation(s)
- Aris Kaltsas
- Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.K.); (M.C.)
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Athanasios Zikopoulos
- Department of Obstetrics and Gynecology, Royal Cornwall Hospital, Truro TR1 3LJ, UK;
| | - Dionysios Vrachnis
- Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Chara Skentou
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Evangelos N. Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (F.D.)
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (F.D.)
| | - Sofoklis Stavros
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece; (S.S.)
| | - Michael Chrisofos
- Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.K.); (M.C.)
| | - Nikolaos Sofikitis
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece; (S.S.)
- Vascular Biology, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK
| | - Athanasios Zachariou
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| |
Collapse
|
3
|
Shcherbitskaia AD, Komarova EM, Milyutina YP, Sagurova YM, Ishchuk MA, Mikhel AV, Ob’edkova KV, Lesik EA, Gzgzyan AM, Tapilskaya NI, Bespalova ON, Kogan IY. Age-Related COVID-19 Influence on Male Fertility. Int J Mol Sci 2023; 24:15742. [PMID: 37958725 PMCID: PMC10649310 DOI: 10.3390/ijms242115742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/29/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
The impact of coronavirus on the reproductive health of men attracts the special attention of many researchers. While studies suggest changes in sperm parameters and the possibility of testicular inflammation, further studies are needed to elucidate any potential age-related changes in these findings, which is the purpose of the present study. The semen quality parameters, cytokine concentration, and markers of the pro- and antioxidant system were assessed in 60 men five to seven months after the coronavirus infection and in 77 controls (without a history of coronavirus infection). Additionally, participants were divided into two age groups: less than 35 years and 35 years or older. Notably increased round cell count in ejaculate and reduced sperm hyaluronan binding ability were observed among post-infection patients younger than 35 years. In the same group, a decline in seminal plasma zinc levels and nitrotyrosine in the cell fraction was found. In men over 35 years of age, Coronavirus Disease 2019 (COVID-19) led to increased sperm DNA fragmentation, a decrease in the total antioxidant capacity, and an elevation in the levels of interleukin-1β and interleukin-10. The concentration of interleukin-1β decreased over time following recovery in all affected patients. The data obtained suggest the potential adverse impact of the coronavirus infection on male reproductive health; however, these effects appear to be age-dependent.
Collapse
Affiliation(s)
- Anastasiia D. Shcherbitskaia
- D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductive Medicine, 199034 St. Petersburg, Russia; (E.M.K.); (Y.P.M.); (Y.M.S.); (M.A.I.); (A.V.M.); (K.V.O.); (E.A.L.); (A.M.G.); (N.I.T.); (O.N.B.); (I.Y.K.)
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Gourinat A, Mazeaud C, Hubert J, Eschwege P, Koscinski I. Impact of paternal age on assisted reproductive technology outcomes and offspring health: a systematic review. Andrology 2023; 11:973-986. [PMID: 36640151 DOI: 10.1111/andr.13385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/18/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND The increase in paternal age and the percentage of births after assisted reproductive technologies (ART) may have consequences on offspring and society's position regarding access to ART must be questioned. Most countries recommend limiting ART to men under 60 years. What is the rationale for this threshold? OBJECTIVE This systematic review assesses scientific arguments to establish links between paternal age, male fertility, and offspring health. MATERIAL AND METHODS Using the PRISMA guidelines, this systematic review of the literature analyzed 111 articles selected after screening PubMed, ScienceDirect, and Web of Science for articles published between January 1, 1995 and December 31, 2021. RESULTS A strong correlation was highlighted between advanced paternal age and a decrease of some sperm parameters (semen volume and sperm motility) and infant morbidity (exponentially increased incidence of achondroplasia and Apert syndrome, and more moderately increased incidence of autism and schizophrenia). The impact of paternal age on pregnancy and fetal aneuploidy rates is more controversial. No association was found with spontaneous abortion rates. DISCUSSION AND CONCLUSION The scientific parameters should be explained to older parents undergoing ART. And for countries that discuss a limit on paternal age for access to ART, the debate requires consideration of social and ethical arguments.
Collapse
Affiliation(s)
| | | | - Jacques Hubert
- Department of Urology, University Hospital, Nancy, France
| | | | | |
Collapse
|
5
|
Omeljaniuk WJ, Laudański P, Miltyk W. The role of miRNA molecules in the miscarriage process. Biol Reprod 2023; 109:29-44. [PMID: 37104617 PMCID: PMC10492520 DOI: 10.1093/biolre/ioad047] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 04/29/2023] Open
Abstract
The etiology and pathogenesis of miscarriage, which is the most common pregnancy complication, have not been fully elucidated. There is a constant search for new screening biomarkers that would allow for the early diagnosis of disorders associated with pregnancy pathology. The profiling of microRNA expression is a promising research area, which can help establish the predictive factors for pregnancy diseases. Molecules of microRNAs are involved in several processes crucial for the development and functioning of the body. These processes include cell division and differentiation, programmed cell death, blood vessel formation or tumorigenesis, and the response to oxidative stress. The microRNAs affect the number of individual proteins in the body due to their ability to regulate gene expression at the post-transcriptional level, ensuring the normal course of many cellular processes. Based on the scientific facts available, this paper presents a compendium on the role of microRNA molecules in the miscarriage process. The expression of potential microRNA molecules as early minimally invasive diagnostic biomarkers may be evaluated as early as the first weeks of pregnancy and may constitute a monitoring factor in the individual clinical care of women in early pregnancy, especially after the first miscarriage. To summarize, the described scientific data set a new direction of research in the development of preventive care and prognostic monitoring of the course of pregnancy.
Collapse
Affiliation(s)
| | - Piotr Laudański
- Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
- Women’s Health Research Institute, Calisia University, Kalisz, Poland
- OVIklinika Infertility Center, Warsaw, Poland
| | - Wojciech Miltyk
- Department of Analysis and Bioanalysis of Medicines, Medical University of Bialystok, Bialystok, Poland
| |
Collapse
|
6
|
Irani D, Balasinor N, Bansal V, Tandon D, Patil A, Singh D. Whole genome bisulfite sequencing of sperm reveals differentially methylated regions in male partners of idiopathic recurrent pregnancy loss cases. Fertil Steril 2023; 119:420-432. [PMID: 36528109 DOI: 10.1016/j.fertnstert.2022.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To study the genome wide alterations in sperm DNA methylation in male partners of idiopathic recurrent pregnancy loss (iRPL) cases and note regions as potential diagnostic markers. DESIGN Case-control study and methylome analysis of human sperm. SETTING Obstetrics and Gynaecology clinics. PATIENT(S) Control group consists of apparently healthy fertile men having fathered a child within the last 2 years (n = 39); and case group consists of male partners of iRPL cases having ≥2 consecutive 1st trimester pregnancy losses (n = 47). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Sperm DNA samples of controls and cases were selected for whole genome bisulfite sequencing analysis based on the previously set thresholds of global methylation levels and methylation levels of imprinted genes (KvDMR and ZAC). Whole genome bisulfite sequencing of selected sperm genomic DNA was performed to identify differentially methylated CpG sites of iRPL cases compared with fertile controls. Pathway analysis of all the differentially methylated genes was done by Database for Annotation, Visualization, and Integrated Discovery annotation tool and Kyoto Encyclopedia of Genes and Genomes tool. Differentially methylated CpGs within genes relevant to embryo and placenta development were selected to further validate their methylation levels in study population by pyrosequencing. RESULT(S) A total of 9497 differentially methylated CpGs with highest enrichment in intronic regions were obtained. In addition, 5352 differentially methylated regions and 2087 differentially methylated genes were noted. Signaling pathways involved in development were enriched on pathway analysis. Select CpGs within genes PPARG, KCNQ1, SETD2, and MAP3K4 showed distinct hypomethylated subpopulations within iRPL study population. CONCLUSION(S) Our study highlights the altered methylation landscape of iRPL sperm, and their possible implications in pathways of embryo and placental development. The CpG sites that are hypomethylated specifically in sperm of iRPL subpopulation can be further assessed as predictive biomarkers.
Collapse
Affiliation(s)
- Delna Irani
- Department of Neuroendocrinology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Nafisa Balasinor
- Department of Neuroendocrinology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Vandana Bansal
- Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Mumbai, India
| | - Deepti Tandon
- Department of Clinical Research, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Anushree Patil
- Department of Clinical Research, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Dipty Singh
- Department of Neuroendocrinology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India.
| |
Collapse
|
7
|
Kaltsas A, Moustakli E, Zikopoulos A, Georgiou I, Dimitriadis F, Symeonidis EN, Markou E, Michaelidis TM, Tien DMB, Giannakis I, Ioannidou EM, Papatsoris A, Tsounapi P, Takenaka A, Sofikitis N, Zachariou A. Impact of Advanced Paternal Age on Fertility and Risks of Genetic Disorders in Offspring. Genes (Basel) 2023; 14:486. [PMID: 36833413 PMCID: PMC9957550 DOI: 10.3390/genes14020486] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/01/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
The average age of fathers at first pregnancy has risen significantly over the last decade owing to various variables, including a longer life expectancy, more access to contraception, later marriage, and other factors. As has been proven in several studies, women over 35 years of age have an increased risk of infertility, pregnancy problems, spontaneous abortion, congenital malformations, and postnatal issues. There are varying opinions on whether a father's age affects the quality of his sperm or his ability to father a child. First, there is no single accepted definition of old age in a father. Second, much research has reported contradictory findings in the literature, particularly concerning the most frequently examined criteria. Increasing evidence suggests that the father's age contributes to his offspring's higher vulnerability to inheritable diseases. Our comprehensive literature evaluation shows a direct correlation between paternal age and decreased sperm quality and testicular function. Genetic abnormalities, such as DNA mutations and chromosomal aneuploidies, and epigenetic modifications, such as the silencing of essential genes, have all been linked to the father's advancing years. Paternal age has been shown to affect reproductive and fertility outcomes, such as the success rate of in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), and premature birth rate. Several diseases, including autism, schizophrenia, bipolar disorders, and paediatric leukaemia, have been linked to the father's advanced years. Therefore, informing infertile couples of the alarming correlations between older fathers and a rise in their offspring's diseases is crucial, so that they can be effectively guided through their reproductive years.
Collapse
Affiliation(s)
- Aris Kaltsas
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Efthalia Moustakli
- Laboratory of Medical Genetics in Clinical Practice, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Athanasios Zikopoulos
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Ioannis Georgiou
- Laboratory of Medical Genetics in Clinical Practice, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Evangelos N. Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Eleftheria Markou
- Department of Microbiology, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Theologos M. Michaelidis
- Department of Biological Applications and Technologies, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
- Biomedical Research Institute, Foundation for Research and Technology-Hellas, 45500 Ioannina, Greece
| | - Dung Mai Ba Tien
- Department of Andrology, Binh Dan Hospital, Ho chi Minh City 70000, Vietnam
| | - Ioannis Giannakis
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | | | - Athanasios Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian Univesity of Athens, 15126 Athens, Greece
| | - Panagiota Tsounapi
- Division of Urology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Nikolaos Sofikitis
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Athanasios Zachariou
- Laboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| |
Collapse
|
8
|
Abstract
Compared to women, increasing male age is not accompanied by such marked changes in reproductive function but changes certainly do happen. These include alterations to the hypothalamo-pituitary-testicular axis, with resultant implications for testosterone production and bioavailability as well as spermatogenesis. There is a decline in sexual function as men age, with a dramatic increase in the prevalence of erectile dysfunction after the age of 40, which is a marker for both clinically evident as well as covert coronary artery disease. Despite a quantitative decline in spermatogenesis and reduced fecundability, the male potential for fertility persists throughout adult life, however there are also increasingly recognised alterations in sperm quality and function with significant implications for offspring health. These changes are relevant to both natural and medically assisted conception.
Collapse
Affiliation(s)
- Sarah Martins da Silva
- Reproductive Medicine Research Group, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, DD1 9SY, Dundee, UK
| | - Richard A Anderson
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK.
| |
Collapse
|
9
|
Roach JM, Arango-Sabogal JC, Smith KC, Foote AK, Verheyen KL, de Mestre AM. Multivariable analysis to determine risk factors associated with abortion in mares. REPRODUCTION AND FERTILITY 2022; 3:RAF-22-0087. [PMID: 36374277 PMCID: PMC9782406 DOI: 10.1530/raf-22-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
Abstract
Risk factors associated with equine reproductive efficiency have been identified along with those associated specifically with early pregnancy loss (EPL). In contrast, no studies have reported risk factors associated with abortion (loss between day 70 and 300 post-cover). Given the causes of abortion differ to those of EPL, likely too will the risk factors. A retrospective cohort study was carried out to identify risk factors associated with abortion in UK and Irish based Thoroughbreds, collecting data on 20 exposure variables over a five-year period. A generalized linear mixed model was utilized to evaluate the associations between exposure variables and abortion, with clustering of observations accounted for at the mare and farm level. Variables with a likelihood ratio test (LRT) p value <0.2 were entered into the model in a forward stepwise approach. Pregnancy outcome was available on 4,439 pregnancies from 2,510 mares. Having had two or more prior abortions (odds ratio (OR) 7.91, 95% confidence interval (CI) 2.86, 21.88), conceiving on the second or subsequent covered estrous cycle (OR 1.84, 95% CI 1.22, 2.78) and conceiving multiple conceptuses (OR 1.68, 95% CI 1.02, 2.76) were associated with an increased risk of abortion compared to null parous, first estrous cycle covers and singleton conceptions respectively. Increasing paternal age (OR 0.95, 95% CI 0.90, 0.99) was associated with a decreasing risk of abortion. Mare and farm variance were not significant in the final model, LRT p=0.43. These findings provide evidence-based data to inform Thoroughbred breeding management practices to help mitigate abortion risk.
Collapse
Affiliation(s)
- J M Roach
- Comparative Biomedical Sciences, Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| | - J C Arango-Sabogal
- Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| | - K C Smith
- Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| | - A K Foote
- Rossdales Laboratories, Newmarket, UK
| | - K L Verheyen
- Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| | - A M de Mestre
- Comparative Biomedical Sciences, Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| |
Collapse
|
10
|
Zhang C, Yan L, Qiao J. Effect of advanced parental age on pregnancy outcome and offspring health. J Assist Reprod Genet 2022; 39:1969-1986. [PMID: 35925538 PMCID: PMC9474958 DOI: 10.1007/s10815-022-02533-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/24/2021] [Indexed: 10/16/2022] Open
Abstract
PURPOSE Fertility at advanced age has become increasingly common, but the aging of parents may adversely affect the maturation of gametes and the development of embryos, and therefore the effects of aging are likely to be transmitted to the next generation. This article reviewed the studies in this field in recent years. METHODS We searched the relevant literature in recent years with the keywords of "advanced maternal/paternal age" combined with "adverse pregnancy outcome" or "birth defect" in the PubMed database and classified the effects of parental advanced age on pregnancy outcomes and birth defects. Related studies on the effect of advanced age on birth defects were classified as chromosomal abnormalities, neurological and psychiatric disorders, and other systemic diseases. The effect of assisted reproduction technology (ART) on fertility in advanced age was also discussed. RESULTS Differences in the definition of the range of advanced age and other confounding factors among studies were excluded, most studies believed that advanced parental age would affect pregnancy outcomes and birth defects in offspring. CONCLUSION To some extent, advanced parental age caused adverse pregnancy outcomes and birth defects. The occurrence of these results was related to the molecular genetic changes caused by aging, such as gene mutations, epigenetic variations, etc. Any etiology of adverse pregnancy outcomes and birth defects related to aging might be more than one. The detrimental effect of advanced age can be corrected to some extent by ART.
Collapse
Affiliation(s)
- Cong Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China
- Savid Medical College (University of Chinese Academy of Sciences), Beijing, 100049, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49, North garden road, Haidian district, Beijing, 100191, People's Republic of China.
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China.
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China.
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China.
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest (Chinese Academy of Medical Sciences), Beijing, 100191, China.
| |
Collapse
|
11
|
Fertility preservation for patients with melanoma. Melanoma Res 2022; 32:303-308. [PMID: 35855660 DOI: 10.1097/cmr.0000000000000840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The advent of immunotherapy and targeted therapy has outstandingly improved the prognosis in subjects with melanoma. Their use is now advocated also in earlier stages as an adjuvant therapy, and some neoadjuvant clinical trials are ongoing. Consequently, survivors free of disease are increasing, as well as those exposed to these new agents. Parenthood in survivors is, therefore, receiving growing interest. Evidence on the effects of immunotherapy and targeted therapy on future fertility is limited, but not entirely reassuring, in particular for immunotherapy. The necessity of delaying pregnancy seeking up to the end of treatments and follow-up (iatrogenic aging) is an additional albeit neglected source of concern, in particular for women in their late 30s. Subjects with melanoma should be informed on the multifaceted issue of future fertility at the time of cancer diagnosis. Available options of fertility preservations, including sperm and oocytes storage, should also be discussed, especially considering that at the age 0-39, melanoma represents the second most frequent neoplasia. In the decision-making process, most attention should be given to sex, age, and exposure to immunotherapy.
Collapse
|
12
|
Setti AS, Braga DPDAF, Guilherme P, Vingris L, Iaconelli A, Borges E. Paternal ageing impacts blastulation and the outcomes of pregnancy at different levels of maternal age: A clustering analysis of 21,960 oocytes and 3837 ICSI cycles. Andrologia 2022; 54:e14485. [PMID: 35698244 DOI: 10.1111/and.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/20/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022] Open
Abstract
The objective of this cross-sectional study was to investigate the impact of paternal age on the outcomes of intracytoplasmic sperm injection (ICSI) cycles at different values of maternal age. A total of 21,960 injected oocytes deriving from 3837 ICSI cycles performed between January 2014 and October 2020, performed in a private university-affiliated in vitro fertilization centre was included. The main effects of maternal and paternal age, as well as the effect of their product (interaction term) on embryo development and pregnancy outcomes were investigated considering the clustering of data. The coefficients for the interaction term were statistically significant for blastocyst development, top-quality blastocyst, implantation, pregnancy, miscarriage, and live-birth rates. For every 1-year increase in paternal age, the odds ratio of live-birth reduces by 1% in females aged 37 years, 1.6% in those aged 38 years, 2.4% in 39-year-old females, 5% in 42-year-old females and so on. An increase in the interaction term by 1 year decreases the pregnancy rate by 0.4% and live-birth rate by 0.8 and increases the miscarriage rate by 1.2%. The slopes of maternal age on blastulation, blastocyst quality, and implantation, pregnancy, miscarriage, and live-birth rate significantly changed (worsened) for every year increase in paternal age.
Collapse
Affiliation(s)
- Amanda Souza Setti
- Fertility Medical Group, São Paulo, Brazil.,Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | | | | | | | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, Brazil.,Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | - Edson Borges
- Fertility Medical Group, São Paulo, Brazil.,Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| |
Collapse
|
13
|
Abstract
Paternal age at conception has been increasing. In this review, we first present the results from the major mammalian animal models used to establish that increasing paternal age does affect progeny outcome. These models provide several major advantages including the possibility to assess multi- transgenerational effects of paternal age on progeny in a relatively short time window. We then present the clinical observations relating advanced paternal age to fertility and effects on offspring with respect to perinatal health, cancer risk, genetic diseases, and neurodevelopmental effects. An overview of the potential mechanism operating in altering germ cells in advanced age is presented. This is followed by an analysis of the current state of management of reproductive risks associated with advanced paternal age. The numerous challenges associated with developing effective, practical strategies to mitigate the impact of advanced paternal age are outlined along with an approach on how to move forward with this important clinical quandary.
Collapse
Affiliation(s)
- Peter T. K. Chan
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Bernard Robaire
- Department of Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
- Department of Obstetrics & Gynecology, McGill University, Montreal, QC, Canada
| |
Collapse
|
14
|
Tomic M, Vrtacnik Bokal E, Stimpfel M. Non-Invasive Preimplantation Genetic Testing for Aneuploidy and the Mystery of Genetic Material: A Review Article. Int J Mol Sci 2022; 23:ijms23073568. [PMID: 35408927 PMCID: PMC8998436 DOI: 10.3390/ijms23073568] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 12/07/2022] Open
Abstract
This review focuses on recent findings in the preimplantation genetic testing (PGT) of embryos. Different preimplantation genetic tests are presented along with different genetic materials and their analysis. Original material concerning preimplantation genetic testing for aneuploidy (PGT-A) was sourced by searching the PubMed and ScienceDirect databases in October and November 2021. The searches comprised keywords such as ‘preimplantation’, ‘cfDNA’; ‘miRNA’, ‘PGT-A’, ‘niPGT-A’, ‘aneuploidy’, ‘mosaicism’, ‘blastocyst biopsy’, ‘blastocentesis’, ‘blastocoel fluid’, ‘NGS’, ‘FISH’, and ‘aCGH’. Non-invasive PGT-A (niPGT-A) is a novel approach to the genetic analysis of embryos. The premise is that the genetic material in the spent embryo culture media (SECM) corresponds to the genetic material in the embryo cells. The limitations of niPGT-A are a lower quantity and lesser quality of the cell-free genetic material, and its unknown origin. The concordance rate varies when compared to invasive PGT-A. Some authors have also hypothesized that mosaicism and aneuploid cells are preferentially excluded from the embryo during early development. Cell-free genetic material is readily available in the spent embryo culture media, which provides an easier, more economic, and safer extraction of genetic material for analysis. The sampling of the SECM and DNA extraction and amplification must be optimized. The origin of the cell-free media, the percentage of apoptotic events, and the levels of DNA contamination are currently unknown; these topics need to be further investigated.
Collapse
Affiliation(s)
- Maja Tomic
- Department of Human Reproduction, Division of Obstetrics and Gynecology, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia; (M.T.); (E.V.B.)
| | - Eda Vrtacnik Bokal
- Department of Human Reproduction, Division of Obstetrics and Gynecology, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia; (M.T.); (E.V.B.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Martin Stimpfel
- Department of Human Reproduction, Division of Obstetrics and Gynecology, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia; (M.T.); (E.V.B.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence:
| |
Collapse
|
15
|
Lim GY, Jung NY, Jun KY, Kang JY, Kim MK, Lee HE, Kim MH, Song J, Kim I, Kim YM. Pregnancy loss and Income in the Republic of Korea using National Health Insurance Service Data, 2008-2014. BMC Public Health 2022; 22:188. [PMID: 35086510 PMCID: PMC8796511 DOI: 10.1186/s12889-022-12588-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 01/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Although unintentional pregnancy loss is common, national representative statistics are lacking in high-income East Asian countries undergoing rapid demographic changes. It is necessary to confirm the income inequality of pregnancy loss even in universal national health insurance. Method Using National Health Insurance Service data between 2008 and 2014, the annual prevalence of pregnancy loss was enumerated, and differences in pregnancy loss according to age and income levels were assessed by multivariable Poisson regression. Joint-point regression was used to examine the trend of pregnancy loss. Result On average, there was a 15.0% annual pregnancy loss among 3,941,020 pregnancy cases from 2008 to 2014. Pregnancy loss inequality increased stepwise with income levels except for the highest income group. After adjusting for income levels, the annual percent change of age-standardized prevalence significantly increased by 2.6% every year since 2011. Conclusion Even in high-income countries with universal national health insurance, income inequality in pregnancy loss is observed. Further appraisal is needed to explain the increasing trend of pregnancy loss between 2011 and 2014 even after adjusting income.
Collapse
Affiliation(s)
- Ga-Young Lim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Na Young Jung
- Incheon Communicable Diseases Center, Incheon, South Korea
| | - Kyo Yeon Jun
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, South Korea
| | - Ji Yeon Kang
- Korea National Enterprise for Clinical Trials, Seoul, South Korea
| | - Mi Kyung Kim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Department of Preventive Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.,Hanyang University School of Public Health, Seoul, South Korea
| | - Hye-Eun Lee
- Korea Institute of Labor Safety and Health, Seoul, South Korea.,Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Myoung-Hee Kim
- Research Institute of Public Health, National Medical Center, Seoul, South Korea
| | - Jaechul Song
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Hanyang University School of Public Health, Seoul, South Korea.,Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Inah Kim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Hanyang University School of Public Health, Seoul, South Korea.,Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Yu-Mi Kim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea. .,Department of Preventive Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea. .,Hanyang University School of Public Health, Seoul, South Korea.
| |
Collapse
|
16
|
Xia X, Chen L, Wang J, Yu X, Gao L, Zhang Y, Diao F, Cui Y, Liu J, Meng Y. Evaluation of Bone Mineral Density in Children Conceived via Assisted Reproductive Technology. Front Endocrinol (Lausanne) 2022; 13:827978. [PMID: 35222282 PMCID: PMC8867605 DOI: 10.3389/fendo.2022.827978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/11/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To investigate bone mineral density (BMD) differences between assisted reproductive technology (ART)-conceived children and naturally conceived (NC) children. STUDY DESIGN This retrospective cohort study included ART-conceived children and controls aged 1 to 12 years assessed with a follow-up protocol. Maternal and paternal background, birth condition, and growth and development indicators were analyzed. RESULTS The ART and NC groups exhibited differences in maternal and paternal childbearing age; maternal weight; maternal body mass index (BMI); maternal alcohol consumption; paternal smoking; delivery method; and serum zinc, iron, and lead levels. Multifactor analysis adjusted for relevant factors showed that paternal childbearing age and group significantly affected the BMD Z score. In the subgroup analysis, in vitro fertilization (IVF) (p=0.026) or intracytoplasmic sperm injection (ICSI) (p=0.008) had a positive impact on the BMD Z score. Male infertility only (p=0.010) or male infertility combined with polycystic ovary syndrome (PCOS) (p=0.026) may affect the BMD Z score. In the embryo transfer cycle subgroup analysis, compared with natural conception, both stimulation cycle fresh embryo transfer (p=0.019) and natural cycle frozen embryo transfer (p=0.006) had a positive effect on the BMD Z score. CONCLUSIONS The BMD levels of the ART and control groups were generally in the normal range. Paternal childbearing age and the use of ART independently affected the BMD Z score of the offspring.
Collapse
Affiliation(s)
- Xinru Xia
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Lingling Chen
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Jing Wang
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Xiang Yu
- Department of Pediatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Li Gao
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yuan Zhang
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Feiyang Diao
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yugui Cui
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Jiayin Liu
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Yan Meng, ; Jiayin Liu,
| | - Yan Meng
- State Key Laboratory of Reproductive Medicine, Center for Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Yan Meng, ; Jiayin Liu,
| |
Collapse
|
17
|
Solle NS, Santiago KM, Feliciano PL, Calkins MM, Fent K, Jahnke S, Parks N, Buren H, Grant C, Burgess JL, Caban-Martinez AJ. Perceptions of Work-Related Health and Cancer Risks Among Women Firefighters: A Qualitative Study. J Occup Environ Med 2021; 63:e846-e852. [PMID: 34538836 PMCID: PMC8814999 DOI: 10.1097/jom.0000000000002386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We use a qualitative method to gain further insight into women firefighters' experiences, perceptions of cancer, health, and safety risks in the fire service. METHODS We conducted six focus groups with U.S. women firefighters. Participants engaged in a 60 to 75-minute, semi-structured discussion and completed a sociodemographic questionnaire. A qualitative descriptive approach was used to inductively create themes. Data collection concluded when saturation was met. RESULTS Forty-nine women firefighters participated. Qualitative results indicated the main health concerns include: occupational cancer risks including, risks related to hazardous exposures, sleep disruption and stress; and women's health concerns including, cancer, pregnancy and breastfeeding, and lack of resources. CONCLUSIONS Women firefighters are concerned about their risk for cancer due to their occupation and identify a lack of resources specific to health and safety needs of women firefighters.
Collapse
Affiliation(s)
- Natasha Schaefer Solle
- Department of Medicine, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
| | - Katerina M. Santiago
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
| | - Paola Louzado Feliciano
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
| | - Miriam M. Calkins
- Division of Field Studies and Engineering (DFSE), National Institute for Occupational Safety and Health, Cincinnati OH 45226, USA
| | - Kenny Fent
- Division of Field Studies and Engineering (DFSE), National Institute for Occupational Safety and Health, Cincinnati OH 45226, USA
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, Leawood, KS, USA
| | | | | | - Casey Grant
- Fire Protection Research Foundation, Quincy, MA 02169, USA
| | - Jefferey L. Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
| |
Collapse
|
18
|
Jung AM, Jahnke SA, Dennis LK, Bell ML, Burgess JL, Jitnarin N, Kaipust CM, Farland LV. Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters. Environ Health 2021; 20:116. [PMID: 34749749 PMCID: PMC8573857 DOI: 10.1186/s12940-021-00800-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence from previous studies suggests that women firefighters have greater risk of some adverse reproductive outcomes. The purpose of this study was to investigate whether women firefighters had greater risk of miscarriage compared to non-firefighters and whether there were occupational factors associated with risk of miscarriage among firefighters. METHODS We studied pregnancies in the United States fire service using data from the Health and Wellness of Women Firefighters Study (n = 3181). We compared the prevalence of miscarriage among firefighters to published rates among non-firefighters using age-standardized prevalence ratios. We used generalized estimating equations to estimate relative risks (RRs) and 95% confidence intervals (CIs) between occupational factors (employment (career/volunteer), wildland firefighter status (wildland or wildland-urban-interface/structural), shift schedule, fire/rescue calls at pregnancy start) and risk of miscarriage, adjusted for age at pregnancy, education, gravidity, BMI, and smoking. We evaluated if associations varied by age at pregnancy or employment. RESULTS Among 1074 firefighters and 1864 total pregnancies, 404 pregnancies resulted in miscarriages (22%). Among most recent pregnancies, 138 resulted in miscarriage (13%). Compared to a study of US nurses, firefighters had 2.33 times greater age-standardized prevalence of miscarriage (95% CI 1.96-2.75). Overall, we observed that volunteer firefighters had an increased risk of miscarriage which varied by wildland status (interaction p-value< 0.01). Among structural firefighters, volunteer firefighters had 1.42 times the risk of miscarriage (95% CI 1.11-1.80) compared to career firefighters. Among wildland/wildland-urban-interface firefighters, volunteer firefighters had 2.53 times the risk of miscarriage (95% CI 1.35-4.78) compared to career firefighters. CONCLUSIONS Age-standardized miscarriage prevalence among firefighters may be greater than non-firefighters and there may be variation in risk of miscarriage by fire service role. Further research is needed to clarify these associations to inform policy and decision-making.
Collapse
Affiliation(s)
- Alesia M Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA.
| | - Sara A Jahnke
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, Leawood, KS, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Nattinee Jitnarin
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, Leawood, KS, USA
| | | | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
- Department of Obstetrics and Gynecology, College of Medicine-Tucson, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
19
|
Li F, Niu A, Feng X, Yan Y, Chen Y. The threshold effect of factors associated with spontaneous abortion in human-assisted reproductive technology. Sci Rep 2021; 11:11368. [PMID: 34059771 PMCID: PMC8166946 DOI: 10.1038/s41598-021-90970-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 05/18/2021] [Indexed: 01/07/2023] Open
Abstract
We explored the independent risk factors associated with cases of spontaneous abortion in infertile patients treated with human-assisted reproductive technology (ART) and established a smooth curve fit and perform a threshold effect analysis can provide guidance and a valuable reference for predicting the probability of spontaneous abortion. This was a retrospective cohort study of 16,097 patients successfully conceived with ART in Shangqiu First People's Hospital from June 2013 to December 2018. Overall, 2,378 (14.77%) had an abortion and 13,719 (85.23%) did not have an abortion. Multivariate logistic regression analysis showed that female age (OR 1.050; 95% CI 1.032–1.069; P < 0.001), male age (OR 1.100; 95% CI 1.086–1.115; P < 0.001), follicular-stimulating hormone (OR 1.049; 95% CI 1.022–1.076; P < 0.001), anti-Mullerian hormone (OR 0.893; 95% CI 0.862–0.925; P < 0.001) and the number of fetuses at pregnancy diagnosis were independent factors associated with spontaneous abortion. The threshold effect analysis found that when female age > 32 years (cut-off point) old, age and the risk of spontaneous abortion were positively correlated. When follicular-stimulating hormone > 6.1 IU/L (cut-off point), follicular-stimulating hormone was positively correlated with the occurrence of spontaneous abortion, When anti-Mullerian hormone ≤ 3.1 ng/mL (cut-off point), anti-Mullerian hormone was negatively correlated with the occurrence of spontaneous abortion and there was a linear positive correlation between antral Follicle Counting and live birth. In addition, the older the male age, the higher the incidence of abortion. The smooth curve fit and threshold effect analyses can provide a more detailed estimate of the probability of spontaneous abortion for pregnant couples.
Collapse
Affiliation(s)
- Fei Li
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - AiQin Niu
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - XingMei Feng
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - Ying Yan
- Department of Molecular Biology, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - Ying Chen
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China.
| |
Collapse
|
20
|
Khambata K, Raut S, Deshpande S, Mohan S, Sonawane S, Gaonkar R, Ansari Z, Datar M, Bansal V, Patil A, Warke H, Balasinor NH. DNA methylation defects in spermatozoa of male partners from couples experiencing recurrent pregnancy loss. Hum Reprod 2021; 36:48-60. [PMID: 33319906 DOI: 10.1093/humrep/deaa278] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 09/16/2020] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION What is the sperm DNA methylation status of imprinted genes in male partners from couples experiencing recurrent pregnancy loss (RPL)? SUMMARY ANSWER Aberrations in sperm DNA methylation status of several imprinted genes, such as insulin like growth factor-2-H19 differentially methylated region (IGF2-H19 DMR), intergenic differentially methylated region (IG-DMR), mesoderm specific transcript (MEST), zinc finger protein which regulates apoptosis and cell cycle arrest (ZAC), DMR in intron 10 of KCNQ1 gene (KvDMR), paternally expressed gene 3 (PEG3) and paternally expressed gene 10 (PEG10), as well as decreased sperm global 5-methylcytosine (5mC) levels, are associated with RPL. WHAT IS KNOWN ALREADY RPL is defined as loss of two or more pregnancies, affecting 1-2% of couples of reproductive age. Although there are several maternal and paternal aetiological factors contributing to RPL, nearly 50% of the cases remain idiopathic. Thus, there is a need to identify putative paternal factors that could be contributing towards pregnancy loss in cases of idiopathic RPL. STUDY DESIGN, SIZE, DURATION In this case-control study, 112 couples undergoing RPL with no identifiable cause were recruited from September 2015 to May 2018. The control group comprised of 106 healthy proven fertile couples with no history of infertility or miscarriage. PARTICIPANTS/MATERIALS, SETTING, METHODS In this study, we investigated the paternal genetic and epigenetic factors that could be associated with RPL. We studied DNA methylation, by pyrosequencing, of selected imprinted genes implicated in embryo development, such as IGF2-H19 DMR, IG-DMR, MEST, ZAC, KvDMR, PEG3, PEG10 and small nuclear ribonucleoprotein polypeptide N (SNRPN) in sperm of men whose partners present RPL. Global DNA methylation in sperm was evaluated by studying 5mC content and long interspersed nuclear element 1 (LINE1) promoter methylation. We also studied polymorphisms by pyrosequencing in the IGF2-H19 DMR as well in the IGF2 promoter in both groups. MAIN RESULTS AND THE ROLE OF CHANCE In the RPL group, we found a significant decrease in the global sperm 5mC levels and significant decrease in DNA methylation at three CpG sites in LINE1 promoter. For IGF2-H19 DMR and IG-DMR, a significant decrease in sperm DNA methylation at specific CpG sites was observed in RPL group. For maternally imprinted genes like MEST, ZAC, KvDMR, PEG3 and PEG10 hypermethylation was noted. Polymorphism studies for IGF2-H19 DMR and IGF2 revealed significant differences in the genotypic frequencies in males. LIMITATIONS, REASONS FOR CAUTION In this study, we analysed the methylation levels of selected candidate imprinted genes implicated in embryo development. Detection of methylation changes occurring at the genome-wide level may reveal further candidate genes having a better distinction between the control and study groups. WIDER IMPLICATIONS OF THE FINDINGS Our study demonstrates that certain polymorphisms and aberrant sperm methylation status in imprinted genes are associated with RPL and could contribute to the aetiology of RPL. This study suggests that investigation of paternal genetic and epigenetic factors could be useful in identification of possible causes of idiopathic RPL. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Department of Science and Technology-Science and Engineering Research Board (EMR/2014/000145) and National Institute for Research in Reproductive Health intramural funds (RA/872/01-2020). All authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Kushaan Khambata
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Sanketa Raut
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Sharvari Deshpande
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Sweta Mohan
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Shobha Sonawane
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Reshma Gaonkar
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Zakiya Ansari
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Mamata Datar
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| | - Vandana Bansal
- Department of Obstetrics and Gynecology, Nowrosjee Wadia Maternity Hospital, Mumbai, India
| | - Anushree Patil
- Department of Reproductive Endocrinology & Infertility, Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Mumbai, India
| | - Himangi Warke
- Department of Obstetrics and Gynecology, Seth G. S. Medical College & King Edward Memorial Hospital (KEM), Mumbai, India
| | - Nafisa H Balasinor
- Neuroendocrinology Department, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai, India
| |
Collapse
|
21
|
Influence of age on sperm characteristics evaluated by light and electron microscopies. Sci Rep 2021; 11:4989. [PMID: 33654135 PMCID: PMC7925541 DOI: 10.1038/s41598-021-84051-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/10/2021] [Indexed: 12/13/2022] Open
Abstract
The impact of male aging on male fertility has only recently become of interest to the scientific community. This study aims to assess the relationship between age and fertility among a sample of men, considering the individual and pathological characteristics. In this retrospective study data of semen analysis and medical history of 1294 Italian male patients were considered. Semen analysis was performed by light microscopy and transmission electron microscopy mathematically elaborated. A generalized linear model was used to explore the influence of male age on semen quality, considering as confounders wine consumption, smoking habits, presence of varicocele, consanguinity and positive semen bacteriological analysis and urethral swab. The mean age of the participants was 36.41 ± 6.379. Male aging without impact of confounders was correlated with a decrease in sperm concentration and motility and an increased in sperm necrosis. Sperm concentration and progressive motility were negatively related to the presence of confounders as wine consumption (sperm motility), urogenital infection (sperm concentration and motility), varicocele (sperm concentration) and consanguinity (sperm motility). Urogenital infection, varicocele and consanguinity positively correlated with sperm necrosis. The most important finding was the observation of a negative effect of male aging on sperm parameters such as concentration, motility, and viability. It is possible to hypothesize age-dependent changes of testicular environment, probably related to reactive oxygen species production. The demonstration, in a large sample of patients, that aging influences sperm quality strongly motivates further research focused on the mechanisms involved in this phenomenon and its effects on offspring fitness.
Collapse
|
22
|
Martin-Moreno PL, Sánchez-Fructuoso AI, Mazuecos A, Mir M, Lopez-Lopez I, González-Rinne A, Coca A, Valero R, Ventura Galiano A, Ridao N, Toapanta-Gaibor NG, Fernández-Tagarro E, Cruzado-Vega L, Pérez-Mir M, Jiménez C. Paternal safety of the use of mycophenolic acid in kidney transplant recipients. Results of the EMVARON study. Clin Transplant 2021; 35:e14256. [PMID: 33599030 DOI: 10.1111/ctr.14256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/06/2021] [Accepted: 02/12/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND The use of mycophenolic acid (MPA) in women during pregnancy causes an increase in miscarriages and birth defects with a typical embryopathy profile. Although epidemiological data does not suggest a greater risk among the offspring of male kidney transplant recipients, the European Medicines Agency and The Spanish Agency of Medicines and Medical Devices introduced the recommendation of using contraceptive methods. METHODS We conducted a national retrospective study in 15 Spanish Kidney Transplant Centers to evaluate the frequency of miscarriages and birth defects between the offspring from male kidney transplants recipients. We included 151 males who had fathered 239 offspring, 225 under MPA and 14 without MPA. RESULTS The results of our study showed an incidence of miscarriages in the MPA group of 9.8%, and of birth defects of 4%. CONCLUSIONS We observed an incidence of miscarriages between the offspring fathered by kidney transplant males under MPA lower than the general population. The incidence of birth defects was similar to the incidence described in other studies and the fact that we did not find the typical embryopathy profile makes it difficult to associate them to the use of MPA. Because of that, we urge the European and Spanish Agencies to reconsider their recommendations for males.
Collapse
Affiliation(s)
- Paloma L Martin-Moreno
- Nephrology Department, Clínica Universidad de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | | | - Marisa Mir
- Nephrology Department, Hospital del Mar, Barcelona, Spain
| | - Isabel Lopez-Lopez
- Nephrology Department, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ana González-Rinne
- Nephrology Department, Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain
| | - Armando Coca
- Nephrology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Rosalía Valero
- Nephrology Department, H.U. Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Ana Ventura Galiano
- Kidney Transplant Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - Natalia Ridao
- Nephrology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Ernesto Fernández-Tagarro
- Nephrology Department, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain
| | | | - Mónica Pérez-Mir
- Kidney Transplant Unit, Nephrology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Jiménez
- Nephrology Department, Hospital Universitario La Paz, Madrid, Spain
| |
Collapse
|
23
|
Starosta A, Gordon CE, Hornstein MD. Predictive factors for intrauterine insemination outcomes: a review. FERTILITY RESEARCH AND PRACTICE 2020; 6:23. [PMID: 33308319 PMCID: PMC7731622 DOI: 10.1186/s40738-020-00092-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/06/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Intrauterine insemination (IUI) is a frequently utilized method of assisted reproduction for patients with mild male factor infertility, anovulation, endometriosis, and unexplained infertility. The purpose of this review is to discuss factors that affect IUI outcomes, including infertility diagnosis, semen parameters, and stimulation regimens. METHODS We reviewed the published literature to evaluate how patient and cycle specific factors affect IUI outcomes, specifically clinical pregnancy rate, live birth rate, spontaneous abortion rate and multiple pregnancy rate. RESULTS Most data support IUI for men with a total motile count > 5 million and post-wash sperm count > 1 million. High sperm DNA fragmentation does not consistently affect pregnancy rates in IUI cycles. Advancing maternal and paternal age negatively impact pregnancy rates. Paternal obesity contributes to infertility while elevated maternal BMI increases medication requirements without impacting pregnancy outcomes. For ovulation induction, letrozole and clomiphene citrate result in similar pregnancy outcomes and are recommended over gonadotropins given increased risk for multiple pregnancies with gonadotropins. Letrozole is preferred for obese women with polycystic ovary syndrome. IUI is most effective for women with ovulatory dysfunction and unexplained infertility, and least effective for women with tubal factor and stage III-IV endometriosis. Outcomes are similar when IUI is performed with ovulation trigger or spontaneous ovulatory surge, and ovulation may be monitored by urine or serum. Most pregnancies occur within the first four IUI cycles, after which in vitro fertilization should be considered. CONCLUSIONS Providers recommending IUI for treatment of infertility should take into account all of these factors when evaluating patients and making treatment recommendations.
Collapse
Affiliation(s)
- Anabel Starosta
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Massachusetts, Boston, USA.
| | - Catherine E Gordon
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Massachusetts, Boston, USA
| | - Mark D Hornstein
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Massachusetts, Boston, USA
| |
Collapse
|
24
|
Halvaei I, Litzky J, Esfandiari N. Advanced paternal age: effects on sperm parameters, assisted reproduction outcomes and offspring health. Reprod Biol Endocrinol 2020; 18:110. [PMID: 33183337 PMCID: PMC7664076 DOI: 10.1186/s12958-020-00668-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/30/2020] [Indexed: 01/08/2023] Open
Abstract
Many factors, including postponement of marriage, increased life expectancy, and improved success with assisted reproductive technologies have been contributing to increased paternal age in developed nations. This increased average paternal age has led to concerns about adverse effects of advanced paternal age on sperm quality, assisted reproductive outcomes, and the health of the offspring conceived by older fathers. This review discusses the association between advanced paternal age and sperm parameters, assisted reproduction success rates, and offspring health.
Collapse
Affiliation(s)
- Iman Halvaei
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Julia Litzky
- Department of Pediatrics, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Navid Esfandiari
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Medical Center, Larner College of Medicine, 111 Colchester Ave, Burlington, VT, 05401, USA.
| |
Collapse
|
25
|
du Fossé NA, van der Hoorn MLP, van Lith JMM, le Cessie S, Lashley EELO. Advanced paternal age is associated with an increased risk of spontaneous miscarriage: a systematic review and meta-analysis. Hum Reprod Update 2020; 26:650-669. [PMID: 32358607 PMCID: PMC7456349 DOI: 10.1093/humupd/dmaa010] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/23/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although spontaneous miscarriage is the most common complication of human pregnancy, potential contributing factors are not fully understood. Advanced maternal age has long been recognised as a major risk factor for miscarriage, being strongly related with fetal chromosomal abnormalities. The relation between paternal age and the risk of miscarriage is less evident, yet it is biologically plausible that an increasing number of genetic and epigenetic sperm abnormalities in older males may contribute to miscarriage. Previous meta-analyses showed associations between advanced paternal age and a broad spectrum of perinatal and paediatric outcomes. This is the first systematic review and meta-analysis on paternal age and spontaneous miscarriage. OBJECTIVE AND RATIONALE The aim of this systematic review and meta-analysis is to evaluate the effect of paternal age on the risk of spontaneous miscarriage. SEARCH METHODS PubMed, Embase and Cochrane databases were searched to identify relevant studies up to August 2019. The following free text and MeSH terms were used: paternal age, father's age, male age, husband's age, spontaneous abortion, spontaneous miscarriage, abortion, miscarriage, pregnancy loss, fetal loss and fetal death. PRISMA guidelines for systematic reviews and meta-analysis were followed. Original research articles in English language addressing the relation between paternal age and spontaneous miscarriage were included. Exclusion criteria were studies that solely focused on pregnancy outcomes following artificial reproductive technology (ART) and studies that did not adjust their effect estimates for at least maternal age. Risk of bias was qualitatively described for three domains: bias due to confounding, information bias and selection bias. OUTCOMES The search resulted in 975 original articles. Ten studies met the inclusion criteria and were included in the qualitative synthesis. Nine of these studies were included in the quantitative synthesis (meta-analysis). Advanced paternal age was found to be associated with an increased risk of miscarriage. Pooled risk estimates for miscarriage for age categories 30-34, 35-39, 40-44 and ≥45 years of age were 1.04 (95% CI 0.90, 1.21), 1.15 (0.92, 1.43), 1.23 (1.06, 1.43) and 1.43 (1.13, 1.81) respectively (reference category 25-29 years). A second meta-analysis was performed for the subgroup of studies investigating first trimester miscarriage. This showed similar pooled risk estimates for the first three age categories and a slightly higher pooled risk estimate for age category ≥45 years (1.74; 95% CI 1.26, 2.41). WIDER IMPLICATIONS Over the last decades, childbearing at later ages has become more common. It is known that frequencies of adverse reproductive outcomes, including spontaneous miscarriage, are higher in women with advanced age. We show that advanced paternal age is also associated with an increased risk of spontaneous miscarriage. Although the paternal age effect is less pronounced than that observed with advanced maternal age and residual confounding by maternal age cannot be excluded, it may have implications for preconception counselling of couples comprising an older aged male.
Collapse
Affiliation(s)
- Nadia A du Fossé
- Department of Gynaecology and Obstetrics, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | | | - Jan M M van Lith
- Department of Gynaecology and Obstetrics, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Saskia le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Eileen E L O Lashley
- Department of Gynaecology and Obstetrics, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| |
Collapse
|
26
|
Al-Mayahi FSA, Jaber SM. Multiple drug resistance of Listeria monocytogenes isolated from aborted women by using serological and molecular techniques in Diwaniyah city/Iraq. IRANIAN JOURNAL OF MICROBIOLOGY 2020; 12:305-312. [PMID: 32994901 PMCID: PMC7502142 DOI: 10.18502/ijm.v12i4.3933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background and Objectives: The study was sought to detect the effect of Listeria monocytogenes on pregnant Iraqi women at Al-Diwaniya hospitals and determination of virulence genes and antimicrobial susceptibility of isolates. Materials and Methods: 360 specimens including blood, urine, vaginal and endocervical were collected from 90 patients with spontaneous abortions. Blood samples were displayed to immunological study and remaining specimens were subjected to bacteriological diagnosis. PCR was used to determine the virulence factors and antimicrobial resistance genes. Results: Fifteen positive samples (16.6%) of patients and thirteen isolates (14.5%) from patients were recognized based on ELISA and PCR assay respectively. The general isolation of L. monocytogenes strains in cases of abortive women was 13/270 (4.8%). L. monocytogenes strains were highly virulent because of presence of virulence factors associated genes, namely actA, hlyA, plcA and prfA in all strains. Multiple drug resistance (MAR) index values of 15.4% of isolates were >0.2. Conclusion: It is necessary for conducting susceptibility testing and to select the suitable antibiotics and avoid the effects of these bacteria in pregnant women.
Collapse
Affiliation(s)
| | - Saja Mahdey Jaber
- Department of Science, School of Nursing, University of Al-Qadisiyah, Diwaniyah, Iraq
| |
Collapse
|
27
|
Warner R, Avery JC, Neuhaus S, Davies MJ. Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 1 — Maternal and Paternal Outcomes. FERTILITY & REPRODUCTION 2020. [DOI: 10.1142/s2661318220500103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Anecdotally, infertility concerns among serving female Australian Defense Force (ADF) members and veterans are perceived to be prevalent, but precise data are lacking. This is the first of two papers that identify reproductive, pregnancy, and infant outcomes in an exclusively Australian military cohort. This initial paper aims to describe maternal and paternal occupation and fertility characteristics of a group of ADF members who deployed to the Middle East during the period 2001–2010. Methods: Utilizing the Middle East Area of Operations Census Study data set, a descriptive analysis was performed on the demographic and clinical variables of the cohort, where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the population. Sociodemographic data and clinical data, including maternal/paternal outcomes, were reported. Results: The self-reported infertility rate was 9%, which was significantly lower than the reported infertility rate in the comparative Australian (non-military) population. All other outcomes were comparable to the Australian population and within normal limits. Conclusions: This survey presents a generally reassuring picture of reproductive health for men and women serving in the ADF with regard to the risk of infertility, pregnancy loss, and perinatal outcomes, although the basis for fertility concerns requires further investigation.
Collapse
Affiliation(s)
- Rachelle Warner
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Jodie C. Avery
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Susan Neuhaus
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Michael J. Davies
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| |
Collapse
|
28
|
Yoon SH, Choi J, Lee WJ, Do JT. Genetic and Epigenetic Etiology Underlying Autism Spectrum Disorder. J Clin Med 2020; 9:E966. [PMID: 32244359 PMCID: PMC7230567 DOI: 10.3390/jcm9040966] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/28/2020] [Accepted: 03/28/2020] [Indexed: 12/19/2022] Open
Abstract
Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by difficulties in social interaction, language development delays, repeated body movements, and markedly deteriorated activities and interests. Environmental factors, such as viral infection, parental age, and zinc deficiency, can be plausible contributors to ASD susceptibility. As ASD is highly heritable, genetic risk factors involved in neurodevelopment, neural communication, and social interaction provide important clues in explaining the etiology of ASD. Accumulated evidence also shows an important role of epigenetic factors, such as DNA methylation, histone modification, and noncoding RNA, in ASD etiology. In this review, we compiled the research published to date and described the genetic and epigenetic epidemiology together with environmental risk factors underlying the etiology of the different phenotypes of ASD.
Collapse
Affiliation(s)
| | | | | | - Jeong Tae Do
- Department of Stem Cell and Regenerative Biotechnology, KU Institute of Technology, Konkuk University, Seoul 05029, Korea; (S.H.Y.); (J.C.); (W.J.L.)
| |
Collapse
|
29
|
Abstract
In the literature there are no unequivocal assessments of the effect of paternal age on the risk of cerebral palsy (CP). The objective of the studies was the analysis of the influence of paternal age on this risk, considering all the important risk factors and division into singleton and twin, as well as term- and preterm-born infants. The inquiry included a group of 278 children with cerebral palsy from selected education-therapeutic institutions in Poland. The control group consisted of the data from medical records of 435 neonates born in God’s Mercy Hospital in Limanowa, Poland. The data were based on a questionnaire designed to obtain information which would make it possible to ascertain the probable etiological factors. Constructed models of logistic regression were used in statistical analysis. The results were presented as the odds ratio (OR) with 95% confidence interval (CI). Though the estimation with a complex model of logistic regression showed no significant effect of paternal age on the occurrence of cerebral palsy, it confirmed it as a stronger predictor compared to maternal age. Disregarding paternal of age while considering maternal age and other risk factors may lead to a bias in the estimations of the risk cerebral palsy.
Collapse
|
30
|
Preconception Hb concentration with risk of spontaneous abortion: a population-based cohort study in over 3·9 million women across rural China. Public Health Nutr 2020; 23:2963-2972. [PMID: 32131921 DOI: 10.1017/s1368980019003811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Evidence on the relationship between maternal Hb concentration and spontaneous abortion (SA) risk is limited and conflicting. The purpose of the study was to evaluate whether maternal preconception anaemia or high Hb concentration is associated with risk of SA. DESIGN A population-based cohort study established between 2013 and 2017. SETTINGS Local maternal and child care service centres in each county. PARTICIPANTS In total, 3 971 428 women aged 20-49 years, who participated in National Free Pre-Pregnancy Checkups Project from 2013 to 2016 and successfully got pregnant before 2017 in rural China. RESULTS A total of 101 700 (2·56 %) women were recorded having SA, with highest SA rate in women with severe anaemia (4·58 %). Compared with women with Hb of 110-149 g/l, the multivariable-adjusted OR for SA was 1·52 (95 % CI: 1·25, 1·86) for women with Hb < 70 g/l, 0·92 (0·84, 1·01) for 70-99 g/l, 0·80 (0·77, 0·83) for 100-109 g/l, 1·11 (1·08, 1·15) for 150-159 g/l, 1·12 (1·04, 1·20) for 160-169 g/l and 1·02 (0·93, 1·12) for ≥ 170 g/l, respectively. An approximate U-shaped curve for the risk of SA with Hb concentrations was observed when Hb concentrations less than 145 g/l, above which the association plateaued (Pnon-linear < 0·001). CONCLUSIONS Severe anaemia and high Hb concentration before pregnancy were associated with an increased risk of SA. Women with mild anaemia prior to pregnancy had lower risk of SA. Underlying mechanisms need to be further studied.
Collapse
|
31
|
Horta F, Vollenhoven B, Healey M, Busija L, Catt S, Temple-Smith P. Male ageing is negatively associated with the chance of live birth in IVF/ICSI cycles for idiopathic infertility. Hum Reprod 2019; 34:2523-2532. [DOI: 10.1093/humrep/dez223] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 11/15/2022] Open
Abstract
Abstract
STUDY QUESTION
Is male age associated with the clinical outcomes of IVF/ICSI cycles for idiopathic infertility after adjustment for female age?
SUMMARY ANSWER
Male ageing is negatively associated with clinical IVF/ICSI outcomes in couples with idiopathic infertility independent of female age.
WHAT IS KNOWN ALREADY
The effect of male age on the outcomes of infertility treatments is controversial and poorly explored. In contrast, fertility is known to decline significantly with female age beyond the mid-30s, and reduced oocyte quality plays an important role. The negative effect of male age on sperm quality is largely associated with an increasing susceptibility to sperm DNA damage. Although increasing maternal age has been linked with poorer oocyte quality, studies on the effect of male age have disregarded the need to control for female age making it difficult to define clearly the role of male age in infertile couples.
STUDY DESIGN, SIZE, DURATION
This retrospective cohort study analysed 2425 cycles of couples with idiopathic infertility selected from a total of 24 411 IVF/ICSI cycles performed at Monash IVF in Australia between 1992 and 2017. The primary outcome was live birth and secondary outcomes were clinical pregnancy and miscarriage.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Couples with primary/secondary infertility who underwent IVF/ICSI cycles with male partners classified as normozoospermic were selected (inclusion criteria). Couples in which the female partner had endometriosis, tubal factors, polycystic ovarian syndrome, ovarian hyperstimulation syndrome, poor responders (≤3 mature oocytes retrieved) and couples with more than 15 cumulus oocyte complexes retrieved or who used cryopreserved gametes were excluded. Binary logistic multilevel modelling was used to identify the effect of male age and female age on clinical outcomes after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: <40, 40–44, 45–49, 50–54, ≥55; female age:<30, 30–34, 35–39, ≥40) predictors.
MAIN RESULTS AND THE ROLE OF CHANCE
There was a negative effect of male age and female age on live birth as odds ratios (OR) with 95% CI for each additional year of age (OR-male age: 0.96 [0.94–0.98]; OR-female age: 0.90 [0.88–0.93] P < 0.001). Potential interactions with male age such as type of treatment (IVF/ICSI), embryo transfer day (Day 3/Day 5) and female age did not have significant associations with outcomes (P > 0.05). Secondary outcomes showed a significant reduction in the odds of clinical pregnancy (OR-male age: 0.97 [0.96–0.99]; OR-female age: 0.92 [0.89–0.94] P < 0.001) and an increase in the odds of miscarriage with older age: male age (OR: 1.05 [1.01–1.08]; P = 0.002); female age (OR: 1.11 [1.05–1.18]; P < 0.001). Worse outcomes were associated with more cycles (clinical pregnancy-OR: 0.96 [0.93–0.99] P = 0.03; live birth-OR: 0.96 [0.92–0.99] P = 0.023) while more inseminated oocytes were associated with better outcomes (clinical pregnancy-OR: 1.06 [1.03–1.06] P < 0.001; live birth-OR: 1.07 [1.04–1.11] P < 0.001). Analyses for age categories showed a gradual worsening of clinical outcomes with increasing male age, with a significantly worse live birth and clinical pregnancy outcomes in males aged older than 50 years compared to males younger than 40 years (P < 0.05).
LIMITATIONS, REASONS FOR CAUTION
This study is limited to the information on confounding factors included. The study may also be limited in its generalizability to a wider population due the strict selection criteria. Age as a category could potentially result in residual confounding due to categorizing a continuous variable.
WIDER IMPLICATIONS OF THE FINDINGS
This study provides information for counselling of couples with idiopathic infertility.
STUDY FUNDING/COMPETING INTEREST(S)
Funded by the Education Program in Reproduction and Development, Department of Obstetrics and Gynaecology, Monash University. None of the authors has any conflict of interest to report.
TRIAL REGISTRATION NUMBER
N/A.
Collapse
Affiliation(s)
- F Horta
- EPRD, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia
| | - B Vollenhoven
- Monash IVF, Melbourne, VIC 3168, Australia
- Monash Health, Melbourne, VIC 3169, Australia
- Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia
| | - M Healey
- Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia
- Royal Women’s Hospital, Melbourne, VIC 3052, Australia
| | - L Busija
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - S Catt
- EPRD, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia
| | - P Temple-Smith
- EPRD, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia
| |
Collapse
|
32
|
Nguyen BT, Chang EJ, Bendikson KA. Advanced paternal age and the risk of spontaneous abortion: an analysis of the combined 2011-2013 and 2013-2015 National Survey of Family Growth. Am J Obstet Gynecol 2019; 221:476.e1-476.e7. [PMID: 31128112 DOI: 10.1016/j.ajog.2019.05.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/08/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Maternal and paternal age at first birth are increasing across the global population. Spontaneous abortion, one of the most common abnormal pregnancy outcomes, is known to occur more frequently with increasing maternal age. However, the relationship of advanced paternal age and spontaneous abortion is poorly understood, and previous results have yielded conflicting results. OBJECTIVE To examine the influence of paternal age on the risk of spontaneous abortion among singleton pregnancies conceived without assisted reproductive technologies. MATERIALS AND METHODS This was a retrospective, case-control study using combined pregnancy data from the Centers for Disease Control and Prevention's 2011-2013 and 2013-2015 National Survey of Family Growth. Spontaneous, singleton pregnancy data from women aged 15-45 years were analyzed. Ongoing pregnancies, induced abortions, ectopic pregnancies, preterm births, and intrauterine fetal deaths were excluded. Bivariate associations of pregnancy outcome (spontaneous abortion at <20 weeks and ≤12 weeks vs. live birth at ≥37 weeks) and paternal age were determined, along with those of maternal age and selected demographic and pregnancy characteristics. Significant associations were included in a multivariable logistic regression, which accounted for multiple pregnancies derived from the same respondent. RESULTS A total of 12,710 pregnancies from 6979 women were analyzed, consisting of 2300 (18.2%) spontaneous abortions and 10,410 (81.8%) term live births. Median maternal and paternal ages were 25 and 28 years, respectively. After adjusting for maternal age, race/ethnicity, socioeconomic status, marital status, and pregnancy intention, pregnancies resulting in spontaneous abortions had 2.05 (95% confidence interval, 1.06-2.20) times the odds of being from a father aged 50 years or older, vs. 25-29 years of age. These relationships remained significant when defining SABs at ≤12 weeks (adjusted odds ratio, 2.30; 95% confidence interval, 1.17-4.52). CONCLUSION Paternal age may increase the odds of spontaneous abortion, independent of selected factors, including demographics, pregnancy intention, and maternal age. This association was robust across several gestational age-based definitions of spontaneous abortion, even after adjustment.
Collapse
|
33
|
Watkins ER, Walker A, Mol E, Jahnke S, Richardson AJ. Women Firefighters' Health and Well-Being: An International Survey. Womens Health Issues 2019; 29:424-431. [PMID: 30930075 DOI: 10.1016/j.whi.2019.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/07/2019] [Accepted: 02/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to identify specific health and well-being issues that women firefighters may experience as part of their daily working practices. Issues identified from this under-represented population can drive future research, education, and strategy to guide safety and health practices. METHODS A total of 840 women firefighters from 14 separate countries (255 United Kingdom and Ireland, 320 North America, 177 Australasia, and 88 mainland Europe) completed the survey over a 4-month period. Questions related to general health and well-being and role-specific health concerns, gender-related issues, and available exercise facilities. RESULTS Women firefighters in North America reported a higher prevalence of lower back (49%) and lower limb (51%) injuries than all other groups. North American respondents reported more heat illnesses (45%) than respondents from other places (36%). Although many participants did not respond, of those who did, 39% thought the menstrual cycle (199/512) or menopause (55/151) affected their work, and 36% were concerned for their ability to meet future job demands. Sixteen percent felt confident they could complete the role after 60 years of age. Women firefighters identified a lack of strength and conditioning support (50%) or lack of gym access (21%). There appears to be poor availability of female-specific personal protective equipment, with availability greatest in the United Kingdom (66%) compared with the sample as a whole (42%). CONCLUSIONS There is a need for female-specific strength and conditioning support and facilities to decrease injury and illness risk and improve longevity. Research and education into gynecological issues, heat exposure, and their effects on women firefighters' fertility and cancer risk is required.
Collapse
Affiliation(s)
- Emily R Watkins
- Extreme Environments Lab, University of Brighton, Welkin Laboratories, Eastbourne, East Sussex, UK
| | - Anthony Walker
- University of Canberra Research Institute for Sports and Exercise, University of Canberra, Canberra, Australia
| | - Eric Mol
- Experts in Firefighting Performance, Dutch Safety Board, Baarn, The Hague, The Netherlands
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, Leawood, Kansas
| | - Alan J Richardson
- Extreme Environments Lab, University of Brighton, Welkin Laboratories, Eastbourne, East Sussex, UK.
| |
Collapse
|
34
|
Cito G, Coccia ME, Picone R, Cocci A, Russo GI, Garaffa G, Fucci R, Bertocci F, Borrani E, Basile V, Micelli E, Criscuoli L, Serni S, Carini M, Natali A. Impact of advanced paternal age on the intracytoplasmic sperm injection (ICSI) outcomes in donor egg cycles. Transl Androl Urol 2019; 8:S22-S30. [PMID: 31143668 DOI: 10.21037/tau.2018.12.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background The purpose of this study is to assess the impact of paternal age on the oocyte-donation outcomes in intracytoplasmic sperm injection (ICSI) cycles. Methods Two hundred and seventy-eight infertile couples were retrospectively involved. Inclusion criteria were: infertility from almost 1 year, normal or sub-fertile seminal parameters, overall oocyte survival rate greater than 85%. Baseline characteristics included male age, recipient age, male body mass index (BMI), smoking, drinking status. Main outcome measures: fertilization rate (FR), cleavage rate (CR), pregnancy rate (PR). Results Patients were categorized in group 1 ≤45, group 2 >45 years. A total of 1,724 frozen oocytes were included. After warming, 1,642 oocytes survived. Median overall oocyte survival rate was 100% [interquartile range (IQR), 85-100%]. Median male age was 44±5.60 years (IQR, 31-70 years). Median recipients age was 42±3.62 years (IQR, 29-50 years). Group 1 included 166 men, group 2 112 men. Two hundred and seventy-eight fresh ICSI cycle were performed. "Two-pronuclear" (2PN) FR was 72.6%±0.20%, CR 93.0%±0.16%, PR 39.6%. Miscarriage rate was 25.5%. Live birth rate per cycles was 29.5%. Comparison between group 1, group 2 and ICSI outcomes confirmed an association with FR, resulting 80.0% (IQR, 67.0-83.0%) and 67.0% (IQR, 50.0-80.0%), respectively (P<0.01). There were no significant differences between the two groups with respect to seminal parameters. Conclusions It would be recommended more emphasis on the advancing male age when counselling older couples who undergo egg donation program.
Collapse
Affiliation(s)
- Gianmartin Cito
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Giorgio Ivan Russo
- Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy
| | - Giulio Garaffa
- Institute of Urology, University College London Hospitals, London, UK
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Bertocci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elena Borrani
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Valentina Basile
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Obstetrics and Gynecology, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Luciana Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| |
Collapse
|
35
|
Brandt JS, Cruz Ithier MA, Rosen T, Ashkinadze E. Advanced paternal age, infertility, and reproductive risks: A review of the literature. Prenat Diagn 2019; 39:81-87. [DOI: 10.1002/pd.5402] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/18/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Justin S. Brandt
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine; Rutgers Robert Wood Johnson Medical School; New Brunswick New Jersey
| | - Mayra A. Cruz Ithier
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine; Rutgers Robert Wood Johnson Medical School; New Brunswick New Jersey
| | - Todd Rosen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine; Rutgers Robert Wood Johnson Medical School; New Brunswick New Jersey
| | - Elena Ashkinadze
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine; Rutgers Robert Wood Johnson Medical School; New Brunswick New Jersey
| |
Collapse
|
36
|
Petersen CG, Mauri AL, Vagnini LD, Renzi A, Petersen B, Mattila M, Comar V, Ricci J, Dieamant F, Oliveira JBA, Baruffi RLR, Franco Jr. JG. The effects of male age on sperm DNA damage: an evaluation of 2,178 semen samples. JBRA Assist Reprod 2018; 22:323-330. [PMID: 30106542 PMCID: PMC6210622 DOI: 10.5935/1518-0557.20180047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 06/30/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effects of male age on sperm DNA damage. METHODS This cross-sectional study included semen samples collected from 2,178 men seen at an infertility clinic. For DNA integrity analysis, the proportions of spermatozoa showing DNA fragmentation (TUNEL assay), abnormal chromatin packaging/underprotamination (chromomycin A3), abnormal mitochondrial membrane potential (MMP/MitoTracker Green), and apoptosis (annexin V) were recorded. For group comparisons, enrolled subjects were divided into three groups based on their ages: ≤35 years; 36-44 years; and ≥45 years. The associations between age and sperm parameters were assessed using Spearman's rank correlation coefficient. RESULTS Although aging did not affect sperm apoptosis (p>.05), sperm DNA fragmentation and MMP deteriorated significantly with age (p<.05). Chromatin packaging/protamination improved significantly with age (p<.05). CONCLUSION Sperm DNA fragmentation worsened with age and was apparently associated with mitochondrial damage. The age-related increase in sperm DNA damage suggests that delaying childbearing, not only in women but also in men, might jeopardize a couple's reproductive capacity. The increase seen in chromatin packaging might represent a protective feature for DNA. However, additional studies must be performed to confirm the results concerning chromatin packaging/protamination.
Collapse
Affiliation(s)
- Claudia G. Petersen
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| | - Ana L. Mauri
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| | - Laura D. Vagnini
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| | - Adriana Renzi
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| | - Bruna Petersen
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| | - Mariana Mattila
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
| | - Vanessa Comar
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
| | - Juliana Ricci
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
| | - Felipe Dieamant
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
| | - Joao Batista A. Oliveira
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| | - Ricardo L. R. Baruffi
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| | - Jose G. Franco Jr.
- Center for Human Reproduction Prof. Franco Jr., Ribeirão
Preto, SP, Brazil
- Paulista Center for Diagnosis, Research, and Training,
Ribeirão Preto, SP, Brazil
| |
Collapse
|
37
|
Inheritance of epigenetic dysregulation from male factor infertility has a direct impact on reproductive potential. Fertil Steril 2018; 110:419-428.e1. [PMID: 29961538 DOI: 10.1016/j.fertnstert.2018.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/28/2018] [Accepted: 04/03/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the epigenetic consequence on the methylome and subsequent transcriptome in euploid blastocysts of male-factor (MF) infertility patients. DESIGN Methylome and transcriptome analysis on individual oligoasthenoteratozoospermia (OAT [MF]) blastocysts. SETTING Infertility clinic. PATIENT(S) Clinical data from 128 couples presenting with OAT (MF) and 118 maternal age-matched control (no MF) subjects undergoing infertility treatment from 2010 to 2014, along with 72 surplus cryopreserved blastocysts donated from 33 couples with their informed consents. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Methyl Maxi-Seq (Zymo Research) was used to determine genome-wide DNA methylation, and small cell number RNA-Seq was used to examine the global transcriptome. Validation experiments were performed with the use of pyrosequencing or quantitative real-time polymerase chain reaction. Statistical analysis used Student t test, analysis of variance in R, Fisher exact test, and pairwise fixed reallocation randomization test where appropriate, with significance at P<.05. RESULT(S) Clinical pregnancy rates were similar between OAT (MF) patients and control (no MF) subjects after euploid embryo transfer. However, the miscarriage rate for OAT (MF) patients was significantly higher (14.7% vs. 2.2%; P<.05). Methylome and transcriptome analyses of individual blastocysts revealed significant alterations in 1,111 CpG sites and 469 transcripts, respectively (P<.05). Pathway analysis elucidated genes involved in "regulation of cellular metabolic process" as universally affected. Validation of the genome-wide approaches was performed for SBF1 and SLC6A9 (P<.05). CONCLUSION(S) Methylation and transcription aberrations in individual OAT (MF) blastocysts illustrate an epigenetic consequence of MF infertility on embryogenesis, significantly altering key developmental genes and affecting embryonic competence. This epigenetic dysregulation provides an explanation for the reduced reproductive potential in OAT (MF) patients despite euploid blastocyst transfers.
Collapse
|
38
|
Abstract
OBJECTIVE The decrease in testosterone levels that occurs with aging has become an important clinical issue both due to the growth of the geriatric population and patient interest in testosterone therapy. The decision to assess for testosterone deficiency and the ability to determine whether the benefits exceed the risks require a comprehensive evaluation of the aging patient. This article is part of a series of papers focused on the endocrinology of aging. This review addresses common issues needed for clinical decision making, including how to interpret test results, differential diagnosis, potential impact of testosterone treatment on insulin resistance and cardiovascular disease, and options for therapy. METHODS Papers reviewed were identified through literature searches conducted on PubMed. RESULTS Assessment of testosterone levels in the geriatric male requires an understanding of the limitations of the assay that is used, the symptoms associated with low testosterone, the impact of comorbid conditions on levels, and risks of therapy. Successful treatment requires setting realistic expectations of the benefits of replacement therapy. CONCLUSION While the prevalence of low testosterone concentrations is increased with aging, the common comorbidities such as obesity and diabetes may contribute to changes in testosterone levels. Clinical trial evidence shows modest benefit for treatment of low testosterone in the presence of symptoms. Assessment of the geriatric male should include evaluation of their testosterone level in the context of their functional status and comorbidities. ABBREVIATIONS CDC = Centers for Disease Control and Prevention; CI = confidence interval; CVD = cardiovascular disease; DXA = dual-energy X-ray absorptiometry; EMAS = European Male Aging Study; FDA = U.S. Food and Drug Administration; FHS = Framingham Heart Study; HDL = high-density lipoprotein; HOMA-IR = homeostasis model assessment of insulin resistance; LH = luteinizing hormone; OR = odds ratio; PSA = prostate-specific antigen; SHBG = sex hormone-binding globulin; T2DM = type 2 diabetes mellitus; vBMD = volumetric bone mineral density.
Collapse
|
39
|
Jahnke SA, Poston WSC, Jitnarin N, Haddock CK. Maternal and Child Health Among Female Firefighters in the U.S. Matern Child Health J 2018; 22:922-931. [PMID: 29423588 PMCID: PMC5918227 DOI: 10.1007/s10995-018-2468-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives Despite increasing attention to the occupational impact of firefighting, little is known specific to the health of women firefighters. In particular, quantitative data is lacking on the impact firefighting has on maternal and child health for women who become pregnant while working as firefighters. Methods A total of 1821 women firefighters responded to requests to complete a self-report survey of questions about pregnancy. Women answered questions about their departments' policies and practices and their own experiences of pregnancy. Those participants who reported a pregnancy while serving as a firefighter were asked detailed questions about their pregnancy and outcomes. Results Female firefighters reported that nearly a quarter of their first pregnancies while in the fire service ended in miscarriage and that increased to a third of pregnancies by the fourth. Rates of pre-term delivery also were high among this population. Conclusions Findings have important implications for policy and practice among women who become pregnant while actively serving in the fire service.
Collapse
Affiliation(s)
- Sara A Jahnke
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, 1920 W. 143d Street, Suite 120, Leawood, KS, 66214, USA.
| | - Walker S C Poston
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, 1920 W. 143d Street, Suite 120, Leawood, KS, 66214, USA
| | - Nattinee Jitnarin
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, 1920 W. 143d Street, Suite 120, Leawood, KS, 66214, USA
| | - Christopher K Haddock
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, 1920 W. 143d Street, Suite 120, Leawood, KS, 66214, USA
| |
Collapse
|
40
|
Yatsenko AN, Turek PJ. Reproductive genetics and the aging male. J Assist Reprod Genet 2018; 35:933-941. [PMID: 29524155 PMCID: PMC6030011 DOI: 10.1007/s10815-018-1148-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/25/2018] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To examine current evidence of the known effects of advanced paternal age on sperm genetic and epigenetic changes and associated birth defects and diseases in offspring. METHODS Review of published PubMed literature. RESULTS Advanced paternal age (> 40 years) is associated with accumulated damage to sperm DNA and mitotic and meiotic quality control mechanisms (mismatch repair) during spermatogenesis. This in turn causes well-delineated abnormalities in sperm chromosomes, both numerical and structural, and increased sperm DNA fragmentation (3%/year of age) and single gene mutations (relative risk, RR 10). An increase in related abnormalities in offspring has also been described, including miscarriage (RR 2) and fetal loss (RR 2). There is also a significant increase in rare, single gene disorders (RR 1.3 to 12) and congenital anomalies (RR 1.2) in offspring. Current research also suggests that autism, schizophrenia, and other forms of "psychiatric morbidity" are more likely in offspring (RR 1.5 to 5.7) with advanced paternal age. Genetic defects related to faulty sperm quality control leading to single gene mutations and epigenetic alterations in several genetic pathways have been implicated as root causes. CONCLUSIONS Advanced paternal age is associated with increased genetic and epigenetic risk to offspring. However, the precise age at which risk develops and the magnitude of the risk are poorly understood or may have gradual effects. Currently, there are no clinical screenings or diagnostic panels that target disorders associated with advanced paternal age. Concerned couples and care providers should pursue or recommend genetic counseling and prenatal testing regarding specific disorders.
Collapse
Affiliation(s)
- Alexander N. Yatsenko
- Department of OB/GYN and Reproductive Sciences, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Room A206, Pittsburgh, PA 15213 USA
| | - Paul J. Turek
- The Turek Clinics, 55 Francisco St., Suite 300, San Francisco, CA 94133 USA
| |
Collapse
|
41
|
Hurley EG, DeFranco EA. Influence of paternal age on perinatal outcomes. Am J Obstet Gynecol 2017; 217:566.e1-566.e6. [PMID: 28784418 DOI: 10.1016/j.ajog.2017.07.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is an increasing trend to delay childbearing to advanced parental age. Increased risks of advanced maternal age and assisted reproductive technologies are widely accepted. There are limited data regarding advanced paternal age. To adequately counsel patients on risk, more research regarding advanced paternal age is necessary. OBJECTIVE We sought to determine the influence of paternal age on perinatal outcomes, and to assess whether this influence differs between pregnancies achieved spontaneously and those achieved with assisted reproductive technology. STUDY DESIGN A population-based retrospective cohort study of all live births in Ohio from 2006 through 2012 was completed. Data were evaluated to determine if advanced paternal age is associated with an increased risk of adverse outcomes in pregnancies. The analysis was stratified by status of utilization of assisted reproductive technology. Generalized linear regression models assessed the association of paternal age on pregnancy complications in assisted reproductive technology and spontaneously conceived pregnancies, after adjusting for maternal age, race, multifetal gestation, and Medicaid status, using Stata software (Stata, Release 12; StataCorp, College Station, TX). RESULTS Paternal age was documented in 82.2% of 1,034,552 live births in Ohio during the 7-year study period. Paternal age ranged from 12-87 years, with a median of 30 (interquartile range, 26-35) years. Maternal age ranged from 11-62 years, with a median of 27 (interquartile range, 22-31) years. The use of assisted reproductive technology in live births increased as paternal age increased: 0.1% <30 years vs 2.5% >60 years, P < .001. After accounting for maternal age and other confounding risk factors, increased paternal age was not associated with a significant increase in the rate of preeclampsia, preterm birth, fetal growth restriction, congenital anomaly, genetic disorder, or neonatal intensive care unit admission. The influence of paternal age on pregnancy outcomes was similar in pregnancies achieved with and without assisted reproductive technology. CONCLUSION Older paternal age does not appear to pose an independent risk of adverse perinatal outcomes, in pregnancies achieved either with or without assisted reproductive technology. However, small effect sizes such as very small risk increases or decreases may not be detectable despite the large sample size in this study of >830,000 births.
Collapse
|
42
|
Levine H, Keinan-Boker L, Leiba A, Derazne E, Rais A, Kark JD. Paternal age and risk of testicular germ cell tumors: a cohort study of 1,000,000 men. Andrology 2017; 5:1124-1130. [PMID: 28950439 DOI: 10.1111/andr.12422] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/28/2017] [Accepted: 08/01/2017] [Indexed: 01/12/2023]
Abstract
Testicular germ cell tumors (TGCT) are the most frequent cancer among young men, with increasing incidence worldwide. Advanced paternal age has been linked to adverse health outcomes in offspring, but reports on the association of paternal age with TGCT are few and inconsistent. We aimed to examine the relationship of paternal age (PAB) at birth with the risk of TGCT and by histologic type: seminoma and non-seminoma. A population-based cohort of 1,056,058 males, examined at ages 16-19 between the years 1980-2011, was linked to the Israel National Cancer Registry to obtain incident TGCT through 2012. We applied multivariable Cox regression. During 16.5 million person-years of follow-up, 1247 incident cases (604 seminomas and 643 non-seminomas) were detected. Increasing PAB was linearly associated with lower risk of TGCT (HRper year = 0.983, 95% CI: 0.974-0.993, p = 0.001), after adjustment for year of birth, years of education, height, cryptorchidism history and origin, and also with additional adjustment for maternal age at birth (MAB) (HRper year = 0.980: 0.965-0.995, p = 0.008). The association was stronger for seminoma (HRper year = 0.968: 0.946-0.989, p = 0.004) and persisted in a subset adjusted for sibship size (HRper year = 0.950: 0.917-0.983, p = 0.003). In the fully adjusted model, young PAB (15-24 vs. ≥30) was a risk factor for seminoma (HR = 1.41: 1.07-1.85, p = 0.014). In models adjusted for PAB, MAB was not associated with risk of TGCT. In conclusion, our findings suggest that young paternal age is a risk factor of TGCT, especially seminoma. The findings warrant further investigation into the possible impact of young paternal age on their offsprings' testes.
Collapse
Affiliation(s)
- H Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - L Keinan-Boker
- The National Cancer Registry, Israel Center for Disease Control, Jerusalem, Israel.,School of Public Health, University of Haifa, Haifa, Israel
| | - A Leiba
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Institute of Nephrology and Hypertension, Sheba Medical Center, Tel Hashomer, Israel
| | - E Derazne
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - A Rais
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - J D Kark
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| |
Collapse
|
43
|
Kumar N, K Singh A, R Choudhari A. Impact of age on semen parameters in male partners of infertile couples in a rural tertiary care center of central India: A cross-sectional study. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.8.497] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
|
44
|
Park YS, Lee SH, Lim CK, Choi HW, An JH, Park CW, Lee HS, Lee JS, Seo JT. Paternal age as an independent factor does not affect embryo quality and pregnancy outcomes of testicular sperm extraction-intracytoplasmic sperm injection in azoospermia. Andrologia 2017; 50. [PMID: 28703337 DOI: 10.1111/and.12864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2017] [Indexed: 12/25/2022] Open
Abstract
This study was performed to evaluate the independent influence of paternal age affecting embryo development and pregnancy using testicular sperm extraction (TESE)-intracytoplasmic sperm injection (ICSI) in obstructive azoospermia (OA) and nonobstructive azoospermia (NOA). Paternal patients were divided into the following groups: ≤30 years, 31-35 years, 36-40 years, 41-45 years and ≥46 years. There were no differences in the rates of fertilisation or embryo quality according to paternal and maternal age. However, clinical pregnancy and implantation rates were significantly lower between those ≥46 years of paternal age compared with other age groups. Fertilisation rate was higher in the OA than the NOA, while embryo quality, pregnancy and delivery results were similar. Clinical pregnancy and implantation rates were significantly lower for patients ≥46 years of paternal age compared with younger age groups. In conclusion, fertilisation using TESE in azoospermia was not affected by the independent influence of paternal age; however, as maternal age increased concomitantly with paternal age, rates of pregnancy and delivery differed between those with paternal age <41 years and ≥46 years. Therefore, paternal age ≥46 years old should be considered when applying TESE-ICSI in cases of azoospermia, and patients should be advised of the associated low pregnancy rates.
Collapse
Affiliation(s)
- Y S Park
- Laboratory of Reproductive Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - S H Lee
- Laboratory of Reproductive Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.,Division of Developmental Biology and Physiology, School of Biosciences and Chemistry, Sungshin Women's University, Seoul, Korea
| | - C K Lim
- Laboratory of Reproductive Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - H W Choi
- Laboratory of Reproductive Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - J H An
- Laboratory of Reproductive Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - C W Park
- Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - H S Lee
- Department of Urology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - J S Lee
- Department of Urology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - J T Seo
- Department of Urology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| |
Collapse
|
45
|
Ventimiglia E, Capogrosso P, Serino A, Boeri L, Colicchia M, La Croce G, Scano R, Papaleo E, Damiano R, Montorsi F, Salonia A. Metabolic syndrome in White-European men presenting for secondary couple's infertility: an investigation of the clinical and reproductive burden. Asian J Androl 2017; 19:368-373. [PMID: 27004539 PMCID: PMC5427796 DOI: 10.4103/1008-682x.175783] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 07/26/2015] [Accepted: 01/08/2016] [Indexed: 11/29/2022] Open
Abstract
We aimed to determine the impact of metabolic syndrome (MetS) on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demographic, clinical, and laboratory data from 167 consecutive secondary infertile men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI; categorised 0 vs 1 vs 2 or higher). NCEP-ATP III criteria were used to define MetS. Semen analysis values were assessed based on the 2010 World Health Organization (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. MetS was found in 20 (12%) of 167 men. Patients with MetS were older (P < 0.001) and had a greater BMI (P < 0.001) compared with those without MetS. MetS patients had lower levels of total testosterone (P = 0.001), sex hormone-binding globulin, inhibin B, and anti-Mόllerian hormone (all P ≤ 0.03), and they were hypogonadal at a higher prevalence (P = 0.01) than patients without MetS. Moreover, MetS patients presented lower values of semen volume, sperm concentration, and sperm normal morphology (all P ≤ 0.03). At multivariate logistic regression analysis, no parameters predicted sperm concentration, normal sperm morphology, and total progressive motility. Our data show that almost 1 of 8 White-European men presenting for secondary couple's infertility is diagnosed with MetS. MetS was found to be associated with a higher prevalence of hypogonadism, decreased semen volume, decreased sperm concentration, and normal morphology in a specific cohort of White-European men.
Collapse
Affiliation(s)
- Eugenio Ventimiglia
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Alessandro Serino
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Luca Boeri
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Michele Colicchia
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Giovanni La Croce
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Roberta Scano
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Enrico Papaleo
- Infertility Unit, Unit of Obstetrics/Gynecology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Rocco Damiano
- Research Doctorate Program in Urology, Magna Graecia University, 88020 Catanzaro, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Research Doctorate Program in Urology, Magna Graecia University, 88020 Catanzaro, Italy
| |
Collapse
|
46
|
Urhoj SK, Andersen PK, Mortensen LH, Davey Smith G, Nybo Andersen AM. Advanced paternal age and stillbirth rate: a nationwide register-based cohort study of 944,031 pregnancies in Denmark. Eur J Epidemiol 2017; 32:227-234. [PMID: 28271174 DOI: 10.1007/s10654-017-0237-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 02/27/2017] [Indexed: 12/21/2022]
Abstract
Advanced paternal age has been associated with a variety of rare conditions and diseases of great public health impact. An increased number of de novo point mutations in sperm with increasing age have been suggested as a mechanism, which would likely also affect fetal viability. We examined the association between paternal age and stillbirth rate in a large nationwide cohort. We identified all pregnancies in Denmark from 1994 to 2010 carried to a gestational age of at least 22 completed weeks (n = 944,031) as registered in national registers and linked to individual register data about the parents. The hazard ratio of stillbirth according to paternal age was estimated, adjusted for maternal age in 1-year categories, year of outcome, and additionally parental educational levels. The relative rate of stillbirth (n = 4946) according to paternal age was found to be J-shaped with the highest hazard ratio for fathers aged more than 40 years when paternal age was modelled using restricted cubic splines. When modelled categorically, the adjusted hazard ratios of stillbirth were as follows: <25, 1.16 (95% confidence interval, CI 1.01-1.34); 25-29, 1.03 (95% CI 0.95-1.11); 35-39, 1.16 (95% CI 1.07-1.26); 40-44, 1.41 (95% CI 1.26-1.59); 45-49, 1.20 (95% CI 0.97-1.49); 50+, 1.58 (95% CI 1.18-2.11), compared with fathers aged 30-34 years. These estimates attenuated slightly when further adjusted for parental education. Our study showed that paternal age was associated with the relative rate of stillbirth in a J-shaped manner with the highest hazard ratios among fathers aged more than 40 years.
Collapse
Affiliation(s)
- Stine Kjaer Urhoj
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, POB 2099, 1014, Copenhagen K, Denmark.
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, POB 2099, 1014, Copenhagen K, Denmark
| | - Laust Hvas Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, POB 2099, 1014, Copenhagen K, Denmark.,Methods and Analysis, Statistics Denmark, Sejrøgade 11, 2100, Copenhagen Ø, Denmark
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Anne-Marie Nybo Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, POB 2099, 1014, Copenhagen K, Denmark
| |
Collapse
|
47
|
Chapuis A, Gala A, Ferrières-Hoa A, Mullet T, Bringer-Deutsch S, Vintejoux E, Torre A, Hamamah S. Sperm quality and paternal age: effect on blastocyst formation and pregnancy rates. Basic Clin Androl 2017; 27:2. [PMID: 28127436 PMCID: PMC5251225 DOI: 10.1186/s12610-016-0045-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/06/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Several studies suggest a decrease in sperm quality in men in the last decades. Therefore, the aim of this work was to assess the influence of male factors (sperm quality and paternal age) on the outcomes of conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). METHODS This retrospective study included all couples who underwent IVF or ICSI at Montpellier University Hospital, France, between 1 January 2010 and 31 December 2015. Exclusion criteria were cycles using surgically retrieved sperm or frozen sperm, with pre-implantation genetic diagnosis or using frozen oocytes. The primary outcomes were the blastulation rate (number of blastocysts obtained at day 5 or day 6/number of embryos in prolonged culture at day 3) and the clinical pregnancy rate. The secondary outcomes were the fertilization and early miscarriage rates. RESULTS In total, 859 IVF and 1632 ICSI cycles were included in this study. The fertilization rate after ICSI was affected by oligospermia. Moreover, in ICSI, severe oligospermia (lower than 0.2 million/ml) led to a reduction of the blastulation rate. Reduced rapid progressive motility affected particularly IVF, with a decrease of the fertilization rate and number of embryos at day 2 when progressive motility was lower than 32%. Paternal age also had a negative effect. Although it was difficult to eliminate the bias linked to the woman's age, pregnancy rate was reduced in IVF and ICSI when the father was older than 51 and the mother older than 37 years. CONCLUSIONS These results allow adjusting our strategies of fertilization technique and embryo transfer. In the case of severe oligospermia, transfer should be carried out at the cleaved embryo stage (day 2-3) due to the very low blastulation rate. When the man is older than 51 years, couples should be aware of the reduced success rate, especially if the woman is older than 37 years. Finally, promising research avenues should be explored, such as the quantification of free sperm DNA, to optimize the selection of male gametes.
Collapse
Affiliation(s)
- Aurélie Chapuis
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
| | - Anna Gala
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
| | - Alice Ferrières-Hoa
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
| | - Tiffany Mullet
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
- Montpellier University, UFR of Medicine, Montpellier, France
| | | | - Emmanuelle Vintejoux
- Gynaecology and Obstetric Department, CHU Montpellier, Montpellier, F-34295 France
| | - Antoine Torre
- Gynaecology and Obstetric Department, CHU Montpellier, Montpellier, F-34295 France
| | - Samir Hamamah
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
- Montpellier University, UFR of Medicine, Montpellier, France
| |
Collapse
|
48
|
Nybo Andersen AM, Urhoj SK. Is advanced paternal age a health risk for the offspring? Fertil Steril 2017; 107:312-318. [PMID: 28088314 DOI: 10.1016/j.fertnstert.2016.12.019] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/18/2016] [Accepted: 12/19/2016] [Indexed: 01/06/2023]
Abstract
In this article we review the epidemiologic evidence for adverse health effects in offspring of fathers of advanced age. First the evidence regarding fetal survival is addressed, and afterward we review the evidence regarding morbidity in children with older fathers. The adverse conditions most consistently associated with increased paternal age are stillbirths, musculo-skeletal syndromes, cleft palate, acute lymphoblastic leukemia and retinoblastoma, and neurodevelopmental disorders in the autism spectrum and schizophrenia. Finally, we consider the public health impact of the increasing paternal age. We conclude that the adverse health effects in children that might be caused by the present increase in paternal age are severe but quantitatively of minor importance. However, identification of morbidities that are more frequent in offspring of older fathers, after having taken any maternal age effects and other confounding into account, may lead to a better understanding of the pathogenesis behind such conditions.
Collapse
Affiliation(s)
| | - Stine Kjaer Urhoj
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
49
|
Rosário GRF, Vidal DS, Silva AV, Franco ACC. The impact of male age on embryo quality: a retrospective study using time-lapse imaging. JBRA Assist Reprod 2016; 20:212-216. [PMID: 28050955 PMCID: PMC5265619 DOI: 10.5935/1518-0557.20160041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 09/09/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aimed to correlate male age with embryo morphokinetic parameters on D3 considering the timing and the exact moment of embryo cleavage. METHODS Time-lapse imaging was used to produce an ideal cleavage curve for the embryos analyzed. The percentage of embryos under the curve was analyzed and correlated with male age. RESULTS 32.6% of the embryos from patients aged 28-33 years were under the curve; 36.2% of the embryos from patients aged 34-39 years were under the curve; 41.3% of the embryos from patients aged 40-45 years were under the curve; and 26.3% of the embryos fro patients aged 46-57 years were under the curve. CONCLUSIONS a statistically non-significant decrease was observed in the percentage of embryos under the optimal cleavage curve on D3 in the group of men aged between 40 and 45 years. Further studies looking into embryos in the blastocyst stage (D5 or D6) are required.
Collapse
Affiliation(s)
| | - Diana S Vidal
- Embryolife Reproductive Medicine Institute, São José dos Campos/SP
| | - Adriana V Silva
- Embryolife Reproductive Medicine Institute, São José dos Campos/SP
| | | |
Collapse
|
50
|
Nevalainen T, Kananen L, Marttila S, Jylhävä J, Jylhä M, Hervonen A, Hurme M. Increased Paternal Age at Conception Is Associated with Transcriptomic Changes Involved in Mitochondrial Function in Elderly Individuals. PLoS One 2016; 11:e0167028. [PMID: 27880854 PMCID: PMC5120832 DOI: 10.1371/journal.pone.0167028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 11/08/2016] [Indexed: 11/18/2022] Open
Abstract
The increased paternal age at conception (PAC) has been associated with autism spectrum disorder (ASD), schizophrenia and other neurodevelopmental disorders, thus raising questions that imply, potential health concerns in the offspring. As opposed to female oogonia, the male germ cells undergo hundreds of cell divisions during the fertile years. Thus, the advanced paternal age is associated with increase of point mutations in the male spermatogonia DNA, implying that this could be the major driving mechanism behind the paternal age effect observed in the offspring. In addition to replication errors, DNA replication fidelity and inefficient DNA repair machinery in the spermatogonia also contribute to the mutagenic load. Our study population consisted of 38 nonagenarians, participants in the Vitality 90+ Study, born in the year 1920 (women n = 25, men n = 13), for whom the parental birth dates were available. The gene expression profile of the study subjects was determined with HumanHT-12 v4 Expression BeadChip from peripheral blood mononuclear cells. We used Spearman's rank correlation to look for the associations of gene expression with paternal age at conception. Associated transcripts were further analyzed with GOrilla and IPA to determine enriched cellular processes and pathways. PAC was associated with the expression levels of 648 transcripts in nonagenarian subjects. These transcripts belonged to the process of mitochondrial translational termination and the canonical pathway of Mitochondrial dysfunction, more specifically of Oxidative phosphorylation. The observed systematic down-regulation of several mitochondrial respiratory chain components implies compromised function in oxidative phosphorylation and thus in the production of chemical energy.
Collapse
Affiliation(s)
- Tapio Nevalainen
- Department of Microbiology and Immunology, School of Medicine, University of Tampere, Tampere, Finland
- Gerontology Research Center, Tampere, Finland
- * E-mail:
| | - Laura Kananen
- Department of Microbiology and Immunology, School of Medicine, University of Tampere, Tampere, Finland
- Gerontology Research Center, Tampere, Finland
| | - Saara Marttila
- Department of Microbiology and Immunology, School of Medicine, University of Tampere, Tampere, Finland
- Gerontology Research Center, Tampere, Finland
| | - Juulia Jylhävä
- Department of Microbiology and Immunology, School of Medicine, University of Tampere, Tampere, Finland
- Gerontology Research Center, Tampere, Finland
| | - Marja Jylhä
- Gerontology Research Center, Tampere, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Antti Hervonen
- Gerontology Research Center, Tampere, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Mikko Hurme
- Department of Microbiology and Immunology, School of Medicine, University of Tampere, Tampere, Finland
- Gerontology Research Center, Tampere, Finland
- Fimlab Laboratories, Tampere, Finland
| |
Collapse
|