1
|
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
|
2
|
Tournaye H, Krausz C, Oates RD. Novel concepts in the aetiology of male reproductive impairment. Lancet Diabetes Endocrinol 2017; 5:544-553. [PMID: 27395771 DOI: 10.1016/s2213-8587(16)30040-7] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 02/09/2016] [Accepted: 04/04/2016] [Indexed: 12/11/2022]
Abstract
Infertility is a widespread problem and a male contribution is involved in 20-70% of affected couples. As a man's fertility relies on the quantity and quality of his sperm, semen analysis is generally used as the proxy to estimate fertility or gain insight into the underlying reasons for infertility. Male reproductive impairment might result from factors that affect sperm production, quality, function, or transport. Although in most men the origin of infertility remains unexplained, genetic causes are increasingly being discovered. In this first of two papers in The Lancet Diabetes and Endocrinology Series on male reproductive impairment, we propose a novel, clinically based aetiological construct with a genetic focus, and consider how this might serve as a helpful way to conceptualise a diagnostic algorithm.
Collapse
Affiliation(s)
- Herman Tournaye
- Centre for Reproductive Medicine, University Hospital of the Free University Brussels, Brussels, Belgium.
| | - Csilla Krausz
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Robert D Oates
- Department of Urology, Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|
3
|
Xue X, Wang WS, Shi JZ, Zhang SL, Zhao WQ, Shi WH, Guo BZ, Qin Z. Efficacy of swim-up versus density gradient centrifugation in improving sperm deformity rate and DNA fragmentation index in semen samples from teratozoospermic patients. J Assist Reprod Genet 2015; 31:1161-6. [PMID: 25015033 DOI: 10.1007/s10815-014-0287-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 06/30/2014] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To compare the efficacy of swim-up and DGC in improving sperm deformity and DNA fragmentation and to determine which method is better in teratozoospermic patients requiring artificial reproduction. METHODS The present study compared the effects of swim-up and density gradient centrifugation (DGC), the two most commonly used semen preparation methods, on sperm deformity rate and DNA fragmentation index (DFI) in semen samples from teratozoospermic patients. RESULTS The results demonstrated that both swim-up and DGC yielded a significantly lower sperm deformity rate and DFI in comparison to unprocessed whole semen, with DGC having more favorable results. Sperm deformity rate in unprocessed whole semen samples was significantly lower in the 20-29 age group than in the 40-49 age group, but no significant difference was observed in DFI between different age groups. There was no significant correlation between sperm deformity rate and DFI. CONCLUSIONS Our findings suggest that enrichment of sperm with normal morphology and intact DNA in teratozoospermic patients could be achieved by both DGC and swim-up procedures, and that DGC is a better method.
Collapse
|
4
|
Atig F, Kerkeni A, Saad A, Ajina M. Effects of reduced seminal enzymatic antioxidants on sperm DNA fragmentation and semen quality of Tunisian infertile men. J Assist Reprod Genet 2013; 34:373-381. [PMID: 23354588 DOI: 10.1007/s10815-013-9936-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/15/2013] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To evaluate levels of sperm DNA fragmentation and enzymatic antioxidant status in seminal plasma of Tunisian fertile and infertile men in order to assess the effects of seminal oxidative stress on sperm DNA integrity and semen quality. METHODS Semen samples from 100 infertile patients (40 oligoasthenoteratozoospermics, 31 teratozoospermics and 29 asthenozoospermics) and 50 fertile men (controls) were analyzed for DNA fragmentation by TUNEL assay and biochemical parameters. Seminal antioxidant activities (Superoxide dismutase, Glutathione peroxidase and Catalase) and malondialdehyde concentrations were measured spectrophotometrically. RESULTS Sperm DNA fragmentation and malondialdehyde levels in infertile groups were more elevated than controls. Nevertheless, the activities of the antioxidant enzymes were significantly lower in abnormal groups compared to normozoospermics. Sperm DNA fragmentation was closely and positively correlated to malondialdehyde levels (r = 0.37, P = 0.008); meanwhile, reduced seminal antioxidant profile was negatively associated to sperm DNA fragmentation. Interestingly, we noted also that sperm DNA fragmentation was negatively correlated to sperm motility (r = -0.54, P < 0.001) and positively associated to the abnormal sperm morphology (r = 0.57, P = 0.002). CONCLUSIONS This report revealed that increased sperm DNA fragmentation can be due to the impaired seminal enzymatic antioxidant profile and increased Lipid peroxidation. Our results sustain that the evaluation of sperm DNA fragmentation and seminal oxidative biomarkers in infertile men is recommended as a consistent prognostic tool for male infertility assessment.
Collapse
Affiliation(s)
- Fatma Atig
- Unit of Reproductive Medicine, University Farhat Hached Hospital, 4000, Soussa, Tunisia. .,Department of Cytogenetic and Reproductive Biology, University Farhat Hached Hospital, 4000, Soussa, Tunisia. .,Research Laboratory of "Trace elements, free radicals and antioxidants", Biophysical Department, Faculty of Medicine, University of Monastir, 5000, Monastir, Tunisia.
| | - Abdelhamid Kerkeni
- Research Laboratory of "Trace elements, free radicals and antioxidants", Biophysical Department, Faculty of Medicine, University of Monastir, 5000, Monastir, Tunisia
| | - Ali Saad
- Unit of Reproductive Medicine, University Farhat Hached Hospital, 4000, Soussa, Tunisia.,Department of Cytogenetic and Reproductive Biology, University Farhat Hached Hospital, 4000, Soussa, Tunisia
| | - Mounir Ajina
- Unit of Reproductive Medicine, University Farhat Hached Hospital, 4000, Soussa, Tunisia.,Department of Cytogenetic and Reproductive Biology, University Farhat Hached Hospital, 4000, Soussa, Tunisia
| |
Collapse
|
5
|
Brahem S, Mehdi M, Elghezal H, Saad A. Detection of DNA fragmentation and meiotic segregation in human with isolated teratozoospermia. J Assist Reprod Genet 2010; 28:41-8. [PMID: 20872065 DOI: 10.1007/s10815-010-9482-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 09/13/2010] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To evaluate levels of DNA fragmentation and chromosomal abnormalities in ejaculated sperm of males with isolated teratozoospermia and to determine if specific sperm morphological types occur simultaneously with these nuclear defects. METHODS Sperm obtained from isolated teratozoospermic men (n = 70) and fertile men (n = 30) were analysed using fluorescence in situ hybridization and TUNEL assay. RESULTS Teratozoospermic men, compared to fertile men, showed significantly higher rates of sex chromosomes disomy, and diploidy. Significant correlations were found between amorphous head, microcephalic head, short tail, and sex chromosomes disomy. Level of sperm DNA fragmentation was significantly higher in teratozoospermic men than in controls and positively correlated to the incidence of macrocephalic heads, amorphous heads, and short flagella. CONCLUSIONS Patients with isolated teratozoospermia have increased levels of DNA fragmentation and chromosomal aneuploidy. Some specific morphological abnormalities were shown to be predictive of chromosomal abnormalities and DNA alteration.
Collapse
Affiliation(s)
- Sonia Brahem
- Department of Cytogenetic and Reproductive biology, Farhat Hached, University Teaching Hospital, Sousse, Tunisia,
| | | | | | | |
Collapse
|
6
|
Zahidov ST, Hohlov AN, Malolina EA, Kulibin AY, Marshak TL. Ageing of the spermatogenesis system. BIOL BULL+ 2010. [DOI: 10.1134/s1062359010010024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
7
|
Perrin A, Caer E, Oliver-Bonet M, Navarro J, Benet J, Amice V, De Braekeleer M, Morel F. DNA fragmentation and meiotic segregation in sperm of carriers of a chromosomal structural abnormality. Fertil Steril 2008; 92:583-9. [PMID: 18706548 DOI: 10.1016/j.fertnstert.2008.06.052] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 06/17/2008] [Accepted: 06/27/2008] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To determine the meiotic segregation and DNA fragmentation in spermatozoa of carriers of a chromosomal structural abnormality. DESIGN Case series. SETTING University hospital. PATIENT(S) Thirty-seven male carriers of a chromosomal structural abnormality (21 with a balanced reciprocal translocation, 7 with a robertsonian translocation, 9 with a pericentric inversion). INTERVENTION(S) Meiotic segregation was analyzed by the human sperm-hamster oocyte fusion technique or by fluorescent in situ hybridization, and DNA fragmentation was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. MAIN OUTCOME MEASURE(S) Relationships between abnormal sperm parameters, DNA fragmentation, and meiotic mechanisms. RESULT(S) The average rates of chromosomally unbalanced spermatozoa were 55.22%, 14.09%, and 18.43% for reciprocal translocation, robertsonian translocation, and pericentric inversion carriers, respectively. The rates of DNA fragmentation were significantly higher in the whole group of carriers of a chromosomal structural abnormality and in each specific group than in the control group. No correlations between sperm DNA fragmentation and parameters of spermogram, age, or percentage of unbalanced chromosomal gametes were found. CONCLUSION(S) The DNA fragmentation rate depends solely on the presence of a chromosomal structural abnormality, and, therefore, a chromosomal structural abnormality predicts DNA fragmentation. Both meiotic segregation and DNA fragmentation studies should be integrated in the genetic exploration of male carriers of a chromosomal structural abnormality.
Collapse
Affiliation(s)
- Aurore Perrin
- Laboratoire d'Histologie, Embryologie et Cytogénétique, Université de Bretagne Occidentale, Faculté de Médecine et des Sciences de la Santé, Brest, France
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Angelopoulou R, Plastira K, Msaouel P. Spermatozoal sensitive biomarkers to defective protaminosis and fragmented DNA. Reprod Biol Endocrinol 2007; 5:36. [PMID: 17760963 PMCID: PMC2000879 DOI: 10.1186/1477-7827-5-36] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2007] [Accepted: 08/30/2007] [Indexed: 11/24/2022] Open
Abstract
Human sperm DNA damage may have adverse effects on reproductive outcome. Infertile men possess substantially more spermatozoa with damaged DNA compared to fertile donors. Although the extent of this abnormality is closely related to sperm function, the underlying etiology of ensuing male infertility is still largely controversial. Both intra-testicular and post-testicular events have been postulated and different mechanisms have been proposed to explain the presence of damaged DNA in human spermatozoa. Three among them, i.e. abnormal chromatin packaging, oxidative stress and apoptosis, are the most studied and discussed in the present review. Furthermore, results from numerous investigations are presented, including our own findings on these pathological conditions, as well as the techniques applied for their evaluation. The crucial points of each methodology on the successful detection of DNA damage and their validity on the appraisal of infertile patients are also discussed. Along with the conventional parameters examined in the standard semen analysis, evaluation of damaged sperm DNA seems to complement the investigation of factors affecting male fertility and may prove an efficient diagnostic tool in the prediction of pregnancy outcome.
Collapse
Affiliation(s)
- Roxani Angelopoulou
- Experimental Embryology Unit, Department of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Konstantina Plastira
- Experimental Embryology Unit, Department of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Pavlos Msaouel
- Experimental Embryology Unit, Department of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Greece
| |
Collapse
|
9
|
Plastira K, Angelopoulou R, Mantas D, Msaouel P, Lyrakou S, Plastiras A, Bolaris S, Baka S, Paparisteidis N. The effects of age on the incidence of aneuploidy rates in spermatozoa of oligoasthenozoospermic patients and its relationship with ICSI outcome. ACTA ACUST UNITED AC 2007; 30:65-72. [PMID: 17073945 DOI: 10.1111/j.1365-2605.2006.00715.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The development of intracytoplasmic sperm injection (ICSI) for treatment of infertility as a result of severe male factor has improved the chances of achieving pregnancy in many infertile couples. However, concerns have been raised regarding the safety of this technique, because natural sperm selection is bypassed. In the present study, 25 oligoasthenozoospermic patients who were divided into two groups according to age: group A, 20-34 (n = 10) and group B, 35-50 (n = 15), were included. Pooling the data of the three semen parameters that were tested (volume, concentration and progressive motility) no statistically significant difference between the two age groups was found. A total of 50 883 decondensed spermatozoa was analysed using the dual and triple colour fluorescence in situ hybridization to estimate the rates of aneuploidy for chromosomes 13, 18, 21, X and Y in the two age groups. There was a significantly higher incidence of disomy for chromosome 21 compared to the other autosomes (chromosomes 13 and 18) in both age groups. The disomy rate of XY was significantly higher in the younger subject group (0.1%) compared to the older group (0.05%, p < 0.05). Statistically significant differences in the mean number of clinical pregnancies and abortions were not observed between the two age groups. The aneuploidy rates for all the analysed chromosomes did not differ significantly, both between and within the two age groups, and as a result there seems to be no effect of male age on chromosome numbers in the spermatozoa and on the ICSI outcome.
Collapse
Affiliation(s)
- Konstantina Plastira
- Department of Histology and Embryology, Medical School, University of Athens, Athens, Greece.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Dakouane-Giudicelli M, Bergère M, Albert M, Sérazin V, Rouillac-Le Sciellour C, Vialard F, Lédée N, Cussenot O, Giudicelli Y, Selva J. Paternité tardive : aspects spermatiques et génétiques. ACTA ACUST UNITED AC 2006; 34:855-9. [PMID: 16931096 DOI: 10.1016/j.gyobfe.2006.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Accepted: 07/09/2006] [Indexed: 11/28/2022]
Abstract
The effect of maternal age on the risk of meiotic abnormality is well documented. In contrast little is known about the effect of the paternal age. The question of the risk related to paternal age is raised because of the increased demand of Assisted Reproduction Techniques for older men. This review focuses on the alterations of male semen parameters, testis histology and genetic risks related to age. The motility, vitality and morphology of spermatozoa and semen volume are found decreasing with age. Histomorphometric studies reveal various alterations including a thickening of the basal membrane when spermatogenesis is arrested. The number of germinal and Sertoli cells decreases with increased age. Up to 95 years old, we could find subjects with complete spermatogenesis. Chromosomal analyses in different studies have provided controversial results. Our investigation on subjects aged from 29 to 102 showed that the rate of aneuploidy in the group of aged subjects with preserved spermatogenesis was not statistically different from the young control group. However the incidence of postmeiotic aneuploidy was increased when spermiogenesis had stopped. On the other hand from epidemiological studies, autosomal dominant diseases are known to be associated with paternal age. However, in the case of achondroplasia and Apert syndrome, direct DNA sperm analysis did not reveal significant increase in the mutation frequency with paternal age.
Collapse
Affiliation(s)
- M Dakouane-Giudicelli
- Unité de pathologie cellulaire et génétique, UPRES EA 2493, faculté de médecine Paris-Ile-de-France Ouest, université de Versailles-Saint-Quentin, centre hospitalier de Poissy-Saint-Germain-en-Laye, 78303 Poissy cedex, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|