Advanced Paternal Age: Implications on Fertility, Pregnancy Outcomes, and Offspring Health

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2026-09-21 DOI:10.1111/jog.70505

Rana Mondal, Mouli Nandi, Ifra Iqbal

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引用次数: 0

Abstract

Aim

To review associations between advanced paternal age (APA) and male reproductive health, assisted reproductive technology (ART) outcomes, pregnancy outcomes, and offspring health, to grade the evidence in each domain, and to address counseling implications.

Methods

Narrative review with a structured, reproducible search. PubMed/MEDLINE was searched from 1 January 1990 to 4 September 2026 using controlled-vocabulary and free-text terms for paternal age and for reproductive, pregnancy, perinatal, and offspring outcomes, limited to human studies in English (1975 records), supplemented by hand-searching, Cochrane reviews, and professional society guidance. Systematic reviews, randomized trials, and large cohorts were prioritized, and confidence in each association was graded qualitatively.

Results

APA (≥ 40 years) is consistently associated with lower semen volume, motility, and viability, higher sperm DNA fragmentation, and a linear increase in de novo mutations. Associations with reduced natural fecundability and modestly higher miscarriage risk are moderately consistent; ART outcomes are heterogeneous and largely attenuated once maternal age is controlled. Large registries show small but consistent associations with stillbirth, preterm birth, selected congenital anomalies, schizophrenia, and autism (relative effects mostly 1.1–3.0); associations with bipolar disorder, ADHD, childhood cancer, and cognitive outcomes are weaker or inconsistent. Because these outcomes are rare, absolute increments remain small. Paternal age alone is not an evidence-based indication for ICSI, sperm DNA fragmentation testing, preimplantation genetic testing, or other add-ons.

Conclusions

APA is associated with measurable changes in sperm biology and modest increases in relative risk for several adverse outcomes, most evident beyond 40 years. Nearly all evidence is observational and should not be read as causal. Paternal age warrants inclusion in reproductive counseling, communicated in absolute terms and without alarm.

Ethical Issue

Beyond biological risks, APA raises concerns about long-term child welfare, emotional well-being, and potential socio-economic implications due to a greater risk of early parental loss.

查看原文本刊更多论文

高龄父亲：对生育能力、妊娠结局和后代健康的影响。

目的：回顾高龄父亲（APA）与男性生殖健康、辅助生殖技术（ART）结局、妊娠结局和后代健康之间的关系，对每个领域的证据进行分级，并提出咨询建议。方法：通过结构化、可重复的检索进行叙述性回顾。PubMed/MEDLINE检索自1990年1月1日至2026年9月4日，使用控制词汇和自由文本术语检索父亲年龄、生殖、妊娠、围产期和后代结局，仅限于英语人类研究（1975年记录），并补充手工检索、Cochrane综述和专业协会指导。优先考虑系统评价、随机试验和大型队列，并对每种关联的可信度进行定性分级。结果：APA（≥40岁）始终与较低的精液体积、活力和活力、较高的精子DNA断裂和新生突变呈线性增加相关。自然生育能力降低和流产风险适度升高的关联是适度一致的；抗逆转录病毒治疗的结果是不同的，一旦控制了产妇年龄，效果就会大大减弱。大型登记显示与死产、早产、特定先天性异常、精神分裂症和自闭症的关联不大，但一致（相对效应大多为1.1-3.0）；与双相情感障碍、多动症、儿童癌症和认知结果的关联较弱或不一致。因为这些结果很少见，所以绝对增量仍然很小。父亲的年龄本身并不是ICSI、精子DNA片段检测、胚胎植入前基因检测或其他附加检测的循证指征。结论：APA与精子生物学的可测量变化和几种不良结局的相对风险适度增加有关，最明显的是超过40年。几乎所有的证据都是观察到的，不应该被解读为因果关系。父亲的年龄应该包括在生殖咨询中，以绝对的方式沟通，不要惊慌。伦理问题：除了生物学风险之外，APA还提出了对儿童长期福利、情感健康以及由于早期失去父母的更大风险而产生的潜在社会经济影响的关注。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.