YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ

Year 2023, , 107 - 114, 30.04.2023

Müge Keskin , Gamze Sinem Çağlar , Ahmet Atik

https://doi.org/10.24938/kutfd.1257537

Abstract

Amaç: İleri anne yaşının yardımcı üreme tekniklerinin (YÜT) başarı şansını düşürdüğü net bir şekilde ortaya konmuştur. İleri baba yaşının spontan gebeliklerde, olumsuz gebelik sonuçlarıyla ve perinatal sonuçlarla ilişkili olduğuna dair çalışmalar vardır. Ancak ileri paternal yaşın, YÜT sonuçlarına etkisine dair az sayıda çalışma vardır. Bu çalışmada in vitro fertilizasyon (IVF) tedavisi gören hastalarda, ileri paternal yaşın siklus sonuçlarına ve perinatal sonuçlara etkisini değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Bu çalışmada; Mayıs, 2021-Aralık,2022 yılları arasında Ankara’da özel bir tüp bebek merkezine başvuran IVF tedavisi alan çiftlerden erkek yaşının 45 ve üstü olduğu olguların retrospektif analizi yapılmıştır. Olguların siklus karakteristikleri değerlendirilerek gebelik olan ve olmayan olgular ile, canlı doğum ile sonuçlanan ve düşükle sonuçlanan olgular siklus özellikleri ve sperm parametreleri açısından karşılaştırılmıştır.

Bulgular: Çalışmaya dahil edilen 76 siklustan 47’si(%61.8) embryo transferi (ET) ile sonuçlandı, geriye kalan 29(%38.2) siklusta, transfer yapılamadı. ET yapılan sikluslardan 29’u(%61.7) gebelik ile sonuçlanırken, 18’inde(%38.2) gebelik görülmedi. Gebelik olan 29 siklustan 13’ü düşük (%44.8), 16’sı (%55.2) ise canlı doğum ile sonuçlandı. Gebelik pozitif veya negatif olan sikluslarla, canlı doğum veya düşük ile sonuçlanan sikluslarda yıkama öncesi ve sonrası sperm parametreleri ile siklus sonuçları bakımından gruplar arasında fark gösterilemedi. Düşük oranı spontan gebelik ve YÜT gebeliklerinde görülenin üstünde bulundu.

Sonuç: YÜT uygulanan hastalarda ileri baba yaşı artmış düşük oranlarıyla ilişkili olabilir, bu hasta grubunda siklus ve gebelik sonuçlarına etki eden faktörleri araştırırken kapsamlı semen analizleri yapılarak sperm sayısı ve motilitesi dışında YÜT sonuçlarını ve perinatal sonuçları etkileyebilecek ek parametrelerin değerlendirilmesi gereklidir.

Keywords

Babalık yaşı, in vitro fertilizasyon, gebelik sonuçları

Supporting Institution

yok

Thanks

Çalışmaya ilişkin hiçbir kurum ya da kişiden finansal destek alınmamıştır.

Effect of Advanced Paternal Age on Perinatal Outcomes in Assisted Reproductive Techniques

Abstract

Objective: It has been well established that advanced maternal age is associated with lower chance of success in assisted reproductive techniques (ART). Adverse pregnancy and perinatal outcomes have also been reported in spontaneous pregnancies with advanced paternal age (APA). However, few studies have assessed the effect of APA on ART outcomes. In this study, we aimed to evaluate the effect of APA on cycle outcomes and perinatal outcomes in patients undergoing IVF (in vitro fertilization) treatment.

Material and Methods: A retrospective analysis of cases with APA (≥45) undergoing IVF treatment in a private center in Ankara between May 2021 and December, 2022 was performed. Cycles in which pregnancy was achieved were compared to cycles unable to achieve pregnancy and cycles that ended up with live birth were compared to the ones ending in abortion in terms of cycle outcomes and sperm parameters.

Results: 76 cycles were included in the study, embryo transfer (ET) was performed in 47(%61.8) of the cycles while in the remaining 29(%38.2) cycles ET was cancelled. Pregnancy was observed in 29(%61.7) cycles while pregnancy could not be achieved in 18(%38.2) of the cycles that included ET. Of the 29 pregnancies, 13(%44.8) ended in miscarriage while 16(%55.2) pregnancies ended in live birth. There was no difference in terms of sperm parameters and cycle outcomes between pregnancy achieved or unachieved cyles. Sperm parameters and cycle outcomes were also comparable between cyles that ended in live birth or miscarriage. Miscarriage rate was higher than the one observed in spontaneous and ART pregnancies.

Conclusion: APA may be associated with increased abortion rates in ART. While investigating the factors affecting cycle and pregnancy outcomes, comprehensive semen analyzes should be performed and additional parameters that may affect ART and perinatal outcomes other than sperm count and motility should be evaluated.

Keywords

Paternal age, in vitro fertilization, pregnancy outcomes

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