Advanced paternal age has been overlooked, and its effect on fertility remains controversial. Previous studies have focused mainly on intracytoplasmic sperm injection (ICSI) cycles in men with oligozoospermia. However, few studies have reported on men with semen parameters within reference ranges. Therefore, we conducted a retrospective cohort study analyzing the reproductive outcomes of couples with non-male-factor infertility undergoing in vitro fertilization (IVF) cycles. In total, 381 cycles included were subgrouped according to paternal age (<35-year-old, 35-39-year-old, or ≥40-year-old), and maternal age was limited to under 35 years. Data on embryo quality and clinical outcomes were analyzed. The results showed that fertilization and high-quality embryo rates were not significantly different (all P > 0.05). The pregnancy rate was not significantly different in the 35-39-year-old group (42.0%; P > 0.05), but was significantly lower in the ≥40-year-old group (26.1%; P < 0.05) than that in the <35-year-old group (40.3%). Similarly, the implantation rate significantly decreased in the ≥40-year-old group (18.8%) compared with that in the <35-year-old group (31.1%) and 35-39-year-old group (30.0%) (both P < 0.05). The live birth rate (30.6%, 21.7%, and 19.6%) was not significantly different across the paternal age subgroups (<35-year-old, 35-39-year-old, and ≥40-year-old, respectively; all P > 0.05), but showed a declining trend. The miscarriage rate significantly increased in the 35-39-year-old group (44.8%) compared with that in the <35-year-old group (21.0%; P < 0.05). No abnormality in newborn birth weight was found. The results indicated that paternal age over 40 years is a key risk factor that influences the assisted reproductive technology success rate even with good semen parameters, although it has no impact on embryo development.
Pregnancy ; Infant, Newborn ; Female ; Humans ; Male ; Adult ; Paternal Age ; Retrospective Studies ; Semen ; Fertilization in Vitro ; Reproductive Techniques, Assisted ; Oligospermia

OBJECTIVES: To study the association between paternal age at childbirth and the risk of autism spectrum disorder (ASD) in offspring. METHODS: In this cross-sectional study, 71 children with ASD who were diagnosed in the Department of Child Healthcare in six hospitals in Guangzhou, Foshan, Beijing, Wuhan, Hangzhou, and Chongqing of China from August 2016 to March 2017 were enrolled as subjects, and 284 typically developing children matched for age, sex, and maternal age at childbirth with the ASD children served as controls. A self-design questionnaire was used to collect the data on social demography, maternal pregnancy, and delivery. The association between paternal age at childbirth and the development of ASD in offspring was evaluated by the logistic regression analysis. RESULTS: After control for demographic factors and pregnancy- and delivery-related factors, the logistic regression analysis showed that a relatively high paternal age at childbirth was significantly associated with the increased risk of ASD in offspring (OR=1.12, 95%CI: 1.02-1.23, P<0.05). After grouping based on the paternal age, the logistic regression analysis showed that paternal age at childbirth of ≥40 years was significantly associated with the risk of ASD in offspring (before adjustment: OR=7.08, 95%CI: 1.77-28.32, P<0.05; after adjustment: OR=8.50, 95%CI: 1.71-42.25, P<0.05). CONCLUSIONS High paternal age at childbirth is significantly associated with the increased risk of ASD in offspring, and paternal age at childbirth ≥40 years may be the high-risk age group for ASD in offspring.
Adult ; Autism Spectrum Disorder ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Maternal Age ; Paternal Age ; Pregnancy ; Risk Factors

OBJECTIVE: As paternal age increases, the quality of sperm decreases due to increased DNA fragmentation and aneuploidy. Higher levels of structural chromosomal aberrations in the gametes ultimately decrease both the morphologic quality of embryos and the pregnancy rate. In this study, we investigated whether paternal age affected the euploidy rate. METHODS: This study was performed using the medical records of patients who underwent in vitro fertilization (IVF) procedures with preimplantation genetic screening (PGS) from January 2016 to August 2017 at a single center. Based on their morphological grade, embryos were categorized as good- or poor-quality blastocysts. The effects of paternal age were elucidated by adjusting for maternal age. RESULTS: Among the 571 total blastocysts, 219 euploid blastocysts were analyzed by PGS (38.4%). When the study population was divided into four groups according to both maternal and paternal age, significant differences were only noted between groups that differed by maternal age (group 1 vs. 3, p=0.031; group 2 vs. 4, p=0.027). Further analysis revealed no significant differences in the euploidy rate among the groups according to the morphological grade of the embryos. CONCLUSION: Paternal age did not have a significant impact on euploidy rates when PGS was performed. An additional study with a larger sample size is needed to clarify the effects of advanced paternal age on IVF outcomes.
Aneuploidy ; Blastocyst ; Chromosome Aberrations ; DNA Fragmentation ; Embryonic Development ; Embryonic Structures ; Female ; Fertilization in Vitro ; Genetic Testing ; Germ Cells ; Humans ; In Vitro Techniques ; Maternal Age ; Medical Records ; Paternal Age ; Pregnancy ; Pregnancy Rate ; Sample Size ; Spermatozoa

PURPOSE: The present study is focused on understanding weight perception related with individual- and school-level multifactorial origins, underestimated and overestimated respectively, in normal body weight adolescents. METHODS: Using the 2017 Korea Youth Risk Behavior Web-based Survey data of 45,902 students from 799 secondary schools, a multilevel multinomial logistic regression analysis was performed where adolescents (level1) were nested within schools (level 2). RESULTS: At the school level, the average school body mass index (BMI, kg/m²) and physical education were associated with weight perception among both boys and girls. In boys, geographic areas were associated with weight underestimation. At the individual level, perceived economic status, weekly allowance, BMI (kg/m²), smartphone usage time (hrs/day) and perceived stress were associated with weight perception among both boys and girls. Age, paternal education, academic achievement and alcohol use were associated with weight perception among girls, while part-time job and physical activity were associated with weight perception among boys. CONCLUSION: Our findings underscore the importance of individual- and school-level environments in developing correct weight perception and have implications for school health education to establish healthy lifestyle behaviors for all adolescents.
Adolescent ; Body Mass Index ; Education ; Female ; Humans ; Ideal Body Weight ; Korea ; Life Style ; Logistic Models ; Motor Activity ; Multilevel Analysis ; Paternal Age ; Physical Education and Training ; Risk-Taking ; School Health Services ; Smartphone ; Weight Perception

PURPOSE: To compare the incidence of twin births with the length of first birth interval (LFBI: from marriage to first birth) among primiparous women. METHODS: The birth certificated data of Korea Statistics from 2010 to 2015 were used for this analysis. There were 1,356,204 births of primiparous women from total birth cases (2,736,296 births). The data involving multiparous women, teenage birth, extra-marital birth, and triplet birth cases were excluded from all analyses. Odds ratio and 95 percent confidence intervals were calculated from logistic regression to examine the risk of twin birth by LFBI adjusted for year of birth, maternal age, paternal age, age difference between couples, and maternal education and occupation. RESULTS: The frequency of LFBI was 41.5 percent in ≤12 months, 30.7 percent in 13~24 months, 13.1 percent in 25~36 months, and 2.1 percent in LFBI of ≥85 months. The mean LFBI was 21.5 months. The incidence of twin birth increased with prolonged LFBI. The twin birth rates per LFBI were 0.8 percent, 3.1 percent, 7.9 percent, and 11.0 percent in LFBI of ≤12 months, 25~36 months, 49~60 months, and 73~84 months, respectively. Odds ratio of twin births rate by LFBI were 1.510 (95% confidence interval: 1.449~1.574) for the LFBI of 13~24 months, 9.839 (9.390~10.309) for 49~60 months, and 13.244 (12.458~14.080) for ≥73~84 months, each compared with LFBI of ≤12 months. Odds ratio of twin birth rate in LFBI of ≤72 months was higher in women aged 35 and older, as compared to women aged ≤34 years. Odds ratio of twin birth rate by maternal age (≤34 years versus ≥35 years) reversed in LFBI of ≥73 months. CONCLUSION: The risk of twin birth increased significantly with prolonged LFBI. There is a need to understand the factors (fertility therapy and etc.) to increased risk of twin birth in prolonged LFBI.
Birth Intervals* ; Birth Order* ; Birth Rate ; Education ; Family Characteristics ; Female ; Humans ; Incidence* ; Korea* ; Logistic Models ; Marriage ; Maternal Age ; Occupations ; Odds Ratio ; Parturition* ; Paternal Age ; Triplets ; Twins*

PURPOSE: To compare the relationship between intertwin birth weight discordance and maternal age at birth. METHODS: There were 51,726 pairs of twins born from 2007 to 2014 according to the birth certificate data of Korea Statistics (3,701,806 births). The data were excluded due to extra marital births, home births, and teenage births. Birth weight discordance rate (%) was calculated according to the following formula: (larger birth weight - smaller birth weight)/(birth weight of the larger twin) ×100. The odds ratio of intertwin birth weight discordance rate (≥25%) in maternal age at birth was calculated by logistic regression adjusted by the year of birth, gestational age, maternal education, infantile gender and paternal age. RESULTS: The mean birth weight of the heavier twin and that of the lighter twin were 2.536 kg and 2.254 kg, respectively. The mean birth weight difference of intertwins was 0.282 kg. The mean birth weight discordance rate by maternal age was 10.5 percent for maternal ages between 20 and 29 years, 11.0 percent for between 30 and 34 years, and 11.4 percent for 35 years and older. The frequency of birth weight discordance level of ≥25 percent increased as the maternal age increased. The rate of birth weight discordance (≥25%) was 7.7 percent for maternal ages between 20 and 29 years, 8.3 percent for between 30 and 34 years, and 8.7 percent in for 35 years and older. Compared with women from 20 to 29 years of age, the odds ratio of ≥25 percent discordance was 1.094 (95% confidence interval: 1.005~1.190) for 30 to 34 years, and 1.164 (1.401~1.301) for 35 years and older. The odds ratio of ≥25 percent discordance for the different-sexed twins was higher than that of the same-sexed twins in overall maternal age groups of 20 to 29 years, 30 to 34 years, and 35 years and older. CONCLUSION: The risk of birth weight discordance level of ≥25 percent was associated with the older maternal age. More research is required to understand the risk factors of intertwin birth weight discordance for older women.
Birth Certificates ; Birth Weight* ; Education ; Female ; Gestational Age ; Humans ; Korea* ; Logistic Models ; Maternal Age* ; Odds Ratio ; Parturition* ; Paternal Age ; Risk Factors ; Twins

PURPOSE: We aimed to analyze the maternal and perinatal factors associated with perinatal outcomes by examining families comprised of Korean fathers, Asian immigrant mothers, and their newborns. METHODS: Medical records of newborn infants admitted to Jeonju Jesus Hospital nursery or ne-onatal intensive care unit (NICU) from January 2004 to June 2013 and their Asian immigrant mothers were reviewed retrospectively. The newborns were divided into two groups depending on whether they were admitted NICU or not, and factors influencing on perinatal outcomes were compared between the two groups. The newborn were divided into the two groups, including those who did not receive inpatient care and those treated in the NICU. The differences between the two groups were analyzed. RESULTS: The study included 180 newborns and 172 mothers, and 94 (52.3%) and 86 (47.7%) newborns were classified as the nursery group and the NICU group, respectively. There were no statistically significant differences between the two groups in terms of the mothers' nationality, maternal age, maternal education level, maternal occupation, residential area, maternal height and weight, maternal weight gain during pregnancy, maternal hepatitis B antigen positivity, maternal parity, paternal age, and age gap between spouses. However, underweight maternal prepregnancy body mass index (BMI) and hemoglobin level over 11.0 g/dL were significantly more frequent in the NICU group in the comparative analysis. The NICU group showed significantly more frequent no iron supplements during pregnancy (OR=4.06) and gestational disease (OR=3.81). CONCLUSION: In cases where married immigrant mothers had underweight prepregnancy BMI, gestational disease, or no iron supplements during pregnancy, their newborns were more likely to have NICU care. Therefore, married immigrant women should have appropriate perinatal care including education about a balanced diet to maintain an appropriate body weight with ensuring an adequate iron supplements intake.
Asian Continental Ancestry Group* ; Body Mass Index ; Body Weight ; Diet ; Education ; Emigrants and Immigrants* ; Ethnic Groups ; Fathers ; Female ; Hepatitis B ; Humans ; Infant, Newborn ; Inpatients ; Intensive Care Units ; Iron ; Marriage* ; Maternal Age ; Medical Records ; Mothers ; Nurseries ; Nurseries, Hospital ; Occupations ; Parity ; Paternal Age ; Perinatal Care ; Pregnancy ; Retrospective Studies ; Spouses ; Thinness ; Weight Gain

PURPOSE: The aim of this study is to investigate the periodical changes of birth rate, perinatal risk factors and outcome of newborns in multi-cultural families with Korean male and non-Korean, Asian female in Gwangju, Chonnnam province. METHODS: We enrolled newborns born in or transferred from other hospital to Chonnam National University Hospital between January 2001 and December 2010. They were categorized into two periods: data from 2001 to 2005 was defined as period I and from 2006 to 2010 was defined as period II. The clinical data of the birth rate, perinatal risk factors and outcome were retrospectively reviewed. RESULTS: Number and rate of newborns in multicultural families increased significantly. The nationality of the mother changed: Vietnamese, Chinese and Cambodian significantly increased; and Japanese and Filipino significantly decreased. As the maternal age tended to be younger in period II, the age gap between the spouses increased, and the paternal age significantly increased, especially in age group of over 45 year-old. Among other perinatal risk factors, premature rupture of membranes and oligohydramnios were decreased. There were no statistical difference in morbidity (except hyperbilirubinemia) and mortality. However, congenital anomalies significantly increased. CONCLUSION: As the number of newborns in multicultural families has increased, the incidence of congenital anomalies also increased. We carefully presumed this result could be caused by increasing paternal age. Careful concern and management are needed for these families and further prospective studies are needed in a larger number of subjects.
Asian Continental Ancestry Group ; Birth Rate ; Ethnic Groups ; Female ; Humans ; Incidence ; Infant, Newborn ; Male ; Maternal Age ; Membranes ; Mothers ; Oligohydramnios ; Parturition ; Paternal Age ; Pregnancy ; Retrospective Studies ; Risk Factors ; Rupture ; Spouses

OBJECTIVETo study the influence of male age on the outcome of conventional IVF-ET.

METHODSBased on male age, 170 couples undergoing conventional IVF-ET were divided into three groups: <35 yr (n = 60), 35 -39 yr (n = 77) and > or = 40 yr (n = 33). We observed the rates of fertilization, cleavage, good quality embryo, implantation, clinical pregnancy and abortion in different groups.

RESULTSThere were no significant differences among the three groups in semen volume ([3.10 +/- 1.22] ml vs [2.84 +/- 1.05] ml vs [2.80 +/- 0.79] ml), sperm concentration ([54.23 +/- 26.07] x 10(6)/ml vs [60.27 +/- 24.80] x 10(6)/ml vs [60.21 +/- 27.42] x 10(6)/ml) and sperm viability ([53.93 +/- 13.25]% vs [56.10 +/- 16.58]% vs [51.82 +/- 15.45]%) (P>0.05). The men of the > or = 40 yr group showed a significantly lower percentage of grade a + b sperm ([40.97 +/- 11.91]%) than those of the <35 and 35 - 39 yr groups ([48.47 +/- 11.78]% and [46.84 +/- 13.51]%) (P<0.05), and morphologically normal sperm ([11.76 +/- 5.97]%) than those of the <35 yr group ([15.25 +/- 6.94]% (P<0.05). The rates of fertilization, cleavage, good quality embryo, implantation, clinical pregnancy were 81.52%, 82.61%, 52.33%, 18.06% and 33.33% in the > or = 40 yr group, with no significant differences from those of the <35 yr group (83.18%, 82.68%, 56.99%, 22.40% and 40.00%) and the 35 - 39 yr group (78.78%, 80.66%, 55.01%, 21.74% and 38.96%) (P>0.05), while the abortion rate was markedly increased in the > or = 40 yr group as compared with the <35 yr group (36.36% vs 8.33%, P>0.05).

CONCLUSIONIncreasing male age is related with decreasing percentages of progressively motile sperm and morphologically normal sperm, but not obviously with the rates of fertilization, good quality embryo, implantation, pregnancy and abortion.

Adult ; Age Factors ; Female ; Fertilization in Vitro ; Humans ; Male ; Middle Aged ; Paternal Age ; Pregnancy ; Pregnancy Outcome

OBJECTIVETo investigate whether advanced paternal age is related to an increased risk of schizophrenia in Chinese Han population.

METHODSA case-control design study was performed. Three hundred and fifty-one patients with schizophrenia and 199 unrelated healthy volunteers were recruited. By using Logistic regression, paternal age was divided into five categories, and maternal age into four categories. Setting the paternal age of 26-30 years as reference, the OR, P values and 95% CI of the other paternal age categories were analyzed, respectively. The participant's sex, age and parental age at birth were used as covariants for adjusting confounding effects.

RESULTSThe OR for schizophrenia in offspring whose paternal age at birth of 31-35 years, 36-40 years, and ≥ 41 years categories were 3.834, 8.805, and 11.619 respectively. The advanced maternal age had no significant effects on the risk for schizophrenia in offspring.

CONCLUSIONThe advanced paternal age was associated with elevated risk for schizophrenia in offspring among a Han Chinese population. Putative biological mechanisms may include accumulated de novo mutations and alterations in epigenetic regulations with aging in spermatogenesis.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Female ; Humans ; Male ; Middle Aged ; Paternal Age ; Schizophrenia ; genetics ; Young Adult