Are Caucasian–European men delaying fatherhood? Results of a 7 year observational study of infertile couples with male factor infertility

Abstract

This study was aimed at assessing presence and predictors of a trend towards more advanced paternal age at presentation in a cohort of 1283 Caucasian-European infertile couples with male factor infertility (MFI) over a short time frame. Multivariate linear regression analysis tested the association between predictors [namely, partners' age, length of infertility at first presentation, patients' comorbidities as scored with the Charlson Comorbidity Index (CCI) and educational status] and patient's age at presentation. Using anova, patient's age at presentation (F ratio: 2.43; p = 0.024) and patients' educational status (χ(2) trend: 142.38; p < 0.001) significantly increased over time. In contrast, length of infertility at first presentation, CCI and partners' age did not significantly change over time (all p ≥ 0.05). Linear regression analyses showed that CCI, educational status and year of presentation were not correlated with patients' age at presentation (all p ≥ 0.05), whereas partners' age (β = 0.170; p < 0.001) and length of infertility (β = 0.123; p = 0.004) were independent predictors of delayed fatherhood. These results showed a significant shift towards advanced paternal age, but a non-significant increase of maternal age at first presentation among Caucasian-European infertile couples with MFI over a short time frame.

Validation of the American Society for Reproductive Medicine guidelines/recommendations in white European men presenting for couple's infertility

“…Therefore, the use of criteria mainly developed for late-onset hypogonadism (19) in infertile men is questionable, at the very least. Infertile patients are usually considered a relatively young population, although a consistent increase in paternal age has been recently described (20). According to our findings, age does not seem to differ in the presence of endocrine abnormalities, calling into question one of the foremost indicators of hypogonadism in the general population (21).…”

Metabolic syndrome in White-European men presenting for secondary couple′s infertility: an investigation of the clinical and reproductive burden

“…Increasing paternal age (above the age of 35–40 years) was found to be associated with delayed conception in a large cohort of British fertile couples,6 with an increased risk of spontaneous pregnancy loss,7 and a decreased success rate for couples undergoing assisted reproductive techniques,8910 although these findings were not always unanimously confirmed 5. Considering the mean age of our secondary infertile patients, along with previous evidence indicating a drift over delayed fatherhood12 and the possible detrimental consequences of this, +MetS infertile patients are at an even higher risk, as the current findings outlined that they are older than infertile not meeting the criteria for MetS.…”

“…More specifically, sperm concentration and the percentage of sperm with normal morphology, sperm motility, and ejaculate volume were found to decrease after 40, 43, and 45 years, respectively, whereas total sperm count declines even earlier 11. A significant role of paternal age has been postulated for a number of genetic factors including numerous severe age-dependent structural chromosomal aberrations, with several X-linked recessive and autosomal dominant disorders have already been clearly confirmed 412…”

Infertility as a proxy of general male health: results of a cross-sectional survey

“…More precisely, within the 34-to 40-year time frame, the first age-related effects on seminal parameters can be observed, and this age range appears to be more and more frequently chosen by European men to father a child (12). The observed trend of delaying fatherhood (12) along with the increasing incidence of health-relevant comorbidities (13) creates a worrisome situation, at least for European males. Despite the interest in assessing the potential impact of any single comorbidity on male reproductive function, little attention has focused on how a patient's general health status (i.e., the combination of all present comorbidities) as a whole may affect fertility.…”

“…Along with comorbidities, age per se is a determinant of male fertility (11). More precisely, within the 34-to 40-year time frame, the first age-related effects on seminal parameters can be observed, and this age range appears to be more and more frequently chosen by European men to father a child (12). The observed trend of delaying fatherhood (12) along with the increasing incidence of health-relevant comorbidities (13) creates a worrisome situation, at least for European males.…”