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YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ

Yıl 2023, Cilt: 25 Sayı: 1, 107 - 114, 30.04.2023
https://doi.org/10.24938/kutfd.1257537

Öz

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.

Destekleyen Kurum

yok

Teşekkür

Çalışmaya ilişkin hiçbir kurum ya da kişiden finansal destek alınmamıştır.

Kaynakça

  • Khandwala YS, Zhang CA, Lu Y, Eisenberg ML. The age of fathers in the USA is rising: an analysis of 168 867 480 births from 1972 to 2015. Hum Reprod. 2017;32(10):2110–6.
  • Klonoff-Cohen H, Natarajan L. The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer. Am J Obstet Gynecol. 2004;191(2):507–51.
  • Pantos K, Athanasiou V, Stefanidis K, Stavrou D, Vaxevanoglou T, Chronopoulou M, et al. Influence of advanced age on the blastocyst development rate and pregnancy rate in assistedreproductive technology. Fertil Steril. 1999;71(6):1144–6.
  • Kleinhaus K, Perrin M, Friedlander Y, Paltiel O, Malaspina D, Harlap S, et al. Paternal age and spontaneous abortion. Obstet Gynecol. 2006;108(2):369–77.
  • Harlap S, Paltiel O, Deutsch L, Knaanie A, Masalha S, Tiram E, et al. Paternal age and preeclampsia. Epidemiology. 2002;13(6):660–7.
  • Khandwala YS, Baker VL, Shaw GM, Stevenson DK, Lu Y, Eisenberg ML, et al. Association of paternal age with perinatal outcomes between 2007 and 2016 in the United States: population based cohort study. BMJ. 2018;363:k4372.
  • McLernon DJ, Maheshwari A, Lee AJ, Bhattacharya S. Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178,898 women. Hum Reprod. 2016;31(3):572–81.
  • Luna M, Finkler E, Barritt J, Bar-Chama N, Sandler B, Copperman AB, et al. Paternal age and assisted reproductive technology outcomein ovum recipients. Fertil Steril. 2009;92(5):1772–5.
  • Aboulghar M, Mansour R, Al-Inany H, Abou-Setta AM, Aboulghar M, Mourad L, et al. Paternal age and outcome of intracytoplasmic sperm injection. Reprod Biomed Online. 2007;14(5):588–92.
  • Stone BA, Alex A, Werlin LB, Marrs RP. Age thresholds for changes in semen parameters in men. Fertil Steril. 2013;100(4):952–8.
  • de La Rochebrochard E, de Mouzon J, Thepot F, Thonneau P, French National IVFRA. Fathers over 40 and increased failure to conceive: the lessons of in vitro fertilization in France. Fertil Steril. 2006;85(5):1420–4.
  • World Health Organization.WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva. World Health Organization, 2021.
  • Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Jansen R and Mortimer D, eds. Towards Reproductive Certainty: Infertility and Genetics Beyond. 2nd ed. Carnforth. Parthenon Press, 1999:377-88.
  • de La Rochebrochard E, Thonneau P.Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study. Hum Reprod. 2002;17(6):1649-56.
  • FIVNAT (French In Vitro National). Pregnancies and births resulting from in vitro fertilization: French national registry, analysis of data 1986 to 1990. Fertil Steril. 1995;64(4):746-56.
  • Jaroudi S, Kakourou G, Cawood S, Doshi A, Ranieri DM, Serhal P, et al. Expression profiling of DNA repair genes in human oocytes and blastocysts using microarrays. Hum Reprod. 2009; 24(10):2649–55.
  • Halvaei I, Litzky J, Esfandiari N. Advanced paternal age: effects on sperm parameters, assisted reproduction outcomes and offspring health. Reprod Biol Endocrinol. 2020;18(1):110.
  • Whitcomb BW, Turzanski-Fortner R, Richter KS, Simon Kipersztok S, Stillman RJ, Levy MJ, et al. Contribution of male age to outcomes in assisted reproductive Technologies addressing methodological challenges. Fertil Steril. 2011;95(1):147-51.
  • Menezol Y, Dale B, Cohen M. DNA damage and repair in human oocytes and embryos: a review. Zygote. 2010;18(4):357–65.
  • Villiani MT, Morini D, Spaggiari G, Falbo AI, Melli B, La Sala GB, et al. Are sperm parameters able to predict the success of assisted reproductive technology? A retrospective analysis of over 22,000 assisted reproductive technology cycles. Andrology. 2022;10(2):310–21.

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

Yıl 2023, Cilt: 25 Sayı: 1, 107 - 114, 30.04.2023
https://doi.org/10.24938/kutfd.1257537

Öz

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.

Kaynakça

  • Khandwala YS, Zhang CA, Lu Y, Eisenberg ML. The age of fathers in the USA is rising: an analysis of 168 867 480 births from 1972 to 2015. Hum Reprod. 2017;32(10):2110–6.
  • Klonoff-Cohen H, Natarajan L. The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer. Am J Obstet Gynecol. 2004;191(2):507–51.
  • Pantos K, Athanasiou V, Stefanidis K, Stavrou D, Vaxevanoglou T, Chronopoulou M, et al. Influence of advanced age on the blastocyst development rate and pregnancy rate in assistedreproductive technology. Fertil Steril. 1999;71(6):1144–6.
  • Kleinhaus K, Perrin M, Friedlander Y, Paltiel O, Malaspina D, Harlap S, et al. Paternal age and spontaneous abortion. Obstet Gynecol. 2006;108(2):369–77.
  • Harlap S, Paltiel O, Deutsch L, Knaanie A, Masalha S, Tiram E, et al. Paternal age and preeclampsia. Epidemiology. 2002;13(6):660–7.
  • Khandwala YS, Baker VL, Shaw GM, Stevenson DK, Lu Y, Eisenberg ML, et al. Association of paternal age with perinatal outcomes between 2007 and 2016 in the United States: population based cohort study. BMJ. 2018;363:k4372.
  • McLernon DJ, Maheshwari A, Lee AJ, Bhattacharya S. Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178,898 women. Hum Reprod. 2016;31(3):572–81.
  • Luna M, Finkler E, Barritt J, Bar-Chama N, Sandler B, Copperman AB, et al. Paternal age and assisted reproductive technology outcomein ovum recipients. Fertil Steril. 2009;92(5):1772–5.
  • Aboulghar M, Mansour R, Al-Inany H, Abou-Setta AM, Aboulghar M, Mourad L, et al. Paternal age and outcome of intracytoplasmic sperm injection. Reprod Biomed Online. 2007;14(5):588–92.
  • Stone BA, Alex A, Werlin LB, Marrs RP. Age thresholds for changes in semen parameters in men. Fertil Steril. 2013;100(4):952–8.
  • de La Rochebrochard E, de Mouzon J, Thepot F, Thonneau P, French National IVFRA. Fathers over 40 and increased failure to conceive: the lessons of in vitro fertilization in France. Fertil Steril. 2006;85(5):1420–4.
  • World Health Organization.WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva. World Health Organization, 2021.
  • Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Jansen R and Mortimer D, eds. Towards Reproductive Certainty: Infertility and Genetics Beyond. 2nd ed. Carnforth. Parthenon Press, 1999:377-88.
  • de La Rochebrochard E, Thonneau P.Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study. Hum Reprod. 2002;17(6):1649-56.
  • FIVNAT (French In Vitro National). Pregnancies and births resulting from in vitro fertilization: French national registry, analysis of data 1986 to 1990. Fertil Steril. 1995;64(4):746-56.
  • Jaroudi S, Kakourou G, Cawood S, Doshi A, Ranieri DM, Serhal P, et al. Expression profiling of DNA repair genes in human oocytes and blastocysts using microarrays. Hum Reprod. 2009; 24(10):2649–55.
  • Halvaei I, Litzky J, Esfandiari N. Advanced paternal age: effects on sperm parameters, assisted reproduction outcomes and offspring health. Reprod Biol Endocrinol. 2020;18(1):110.
  • Whitcomb BW, Turzanski-Fortner R, Richter KS, Simon Kipersztok S, Stillman RJ, Levy MJ, et al. Contribution of male age to outcomes in assisted reproductive Technologies addressing methodological challenges. Fertil Steril. 2011;95(1):147-51.
  • Menezol Y, Dale B, Cohen M. DNA damage and repair in human oocytes and embryos: a review. Zygote. 2010;18(4):357–65.
  • Villiani MT, Morini D, Spaggiari G, Falbo AI, Melli B, La Sala GB, et al. Are sperm parameters able to predict the success of assisted reproductive technology? A retrospective analysis of over 22,000 assisted reproductive technology cycles. Andrology. 2022;10(2):310–21.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Araştırma
Yazarlar

Müge Keskin 0000-0001-7510-7898

Gamze Sinem Çağlar 0000-0003-1956-0908

Ahmet Atik 0000-0002-4202-7055

Erken Görünüm Tarihi 30 Nisan 2023
Yayımlanma Tarihi 30 Nisan 2023
Gönderilme Tarihi 28 Şubat 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 25 Sayı: 1

Kaynak Göster

APA Keskin, M., Çağlar, G. S., & Atik, A. (2023). YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 25(1), 107-114. https://doi.org/10.24938/kutfd.1257537
AMA Keskin M, Çağlar GS, Atik A. YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ. Kırıkkale Üni Tıp Derg. Nisan 2023;25(1):107-114. doi:10.24938/kutfd.1257537
Chicago Keskin, Müge, Gamze Sinem Çağlar, ve Ahmet Atik. “YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 25, sy. 1 (Nisan 2023): 107-14. https://doi.org/10.24938/kutfd.1257537.
EndNote Keskin M, Çağlar GS, Atik A (01 Nisan 2023) YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 25 1 107–114.
IEEE M. Keskin, G. S. Çağlar, ve A. Atik, “YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ”, Kırıkkale Üni Tıp Derg, c. 25, sy. 1, ss. 107–114, 2023, doi: 10.24938/kutfd.1257537.
ISNAD Keskin, Müge vd. “YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 25/1 (Nisan 2023), 107-114. https://doi.org/10.24938/kutfd.1257537.
JAMA Keskin M, Çağlar GS, Atik A. YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ. Kırıkkale Üni Tıp Derg. 2023;25:107–114.
MLA Keskin, Müge vd. “YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, c. 25, sy. 1, 2023, ss. 107-14, doi:10.24938/kutfd.1257537.
Vancouver Keskin M, Çağlar GS, Atik A. YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ. Kırıkkale Üni Tıp Derg. 2023;25(1):107-14.

Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.