| Infertility affects 10-15%of couples currently,with paternal factors accounting for nearly 50%of infertility cases.Many infertile patients seek treatments of assisted reproductive technology(ARTs).However,the success rate of ART is not 100%,among which the success rate of artificial insemination is about 10%-15%,and the success rate of in vitro fertilization is about 40%-60%.Moreover,spontaneous abortion is still likely to occur after successful assisted pregnancy,with approximately 50%to 70%of spontaneous abortion due to chromosomal abnormalities in the embryo.Therefore,to prevent pregnancy loss,it is crucial to identify the risk factors of chromosomal aberration-related miscarriages during treatment with assisted reproductive technology.At present,there are many researches regarding the effect of female partner factors on the embryo chromosome.Although male partners are equally responsible for infertility,the impact of male factors on pregnancy outcomes is often overlooked.Moreover,the effect of male partner characteristics on chromosomal aberrations in aborted fetuses remains inconclusive.Genome-wide testing for the miscarried chorionic villi samples(CVS)using array-based single nucleotide polymorphisms(SNPs)has greatly contributed to understanding the etiology of spontaneous miscarriages due to genetic abnormalities.Therefore,we investigated the effects of paternal characteristics,including age,body mass index(BMI),and semen parameters on chromosomal aberration-related miscarriages in couples that underwent treatment with assisted reproductive technology.ObjectiveTo examine the effect of male partner age,body mass index and sperm parameters on chromosomal aberration-related miscarriages during treatment with assisted reproductive technology.Materials and Methods1.DesignA retrospective cohort,single-center study.2.PatientsA total of 94018 patients that underwent ART in our fertility clinic from January 2013 to May 2018 due to various infertility factors were selected.Among these patients,5272 suffered from involuntary miscarriages.Ultimately,1103 patients sent their miscarried chorionic villus to our pre-implantation genetic diagnosis centre for genetic analysis.After screening,925 participants were remaining for further analysis.3.InterventionAfter cautiously diagnosing spontaneous miscarriage,curettage of the uterine cavity was performed and the obtained chorionic villi were routinely sent to the pre-implantation genetic diagnosis center for single nucleotide polymorphism array analysis to identify the etiology of this adverse reproductive outcome.4.StatisticsThe numbers and percentages of abnormal chromosomal karyotypes between different male partner age,BMI,and semen parameters groups were compared.Trend chi-square test was used to confirm that the trend of chromosomal aberration rate was changed with male partner age.Univariate and multivariate logistic regression analysis were used to determine potential risk factors for fetal development of chromosomal abnormalities.Multivariate logistic regression was carried out to adjust potential confounding factors and determine the role of male partner age,BMI,and semen parameters on miscarriage due to chromosomal abnormalities.The analyses were performed using IBM SPSS Statistics 25(IBM Corp.).Results1.Effect of male partner age on chromosomal aberration-related miscarriages.The frequency of abnormal karyotypes in fetus positively corresponding to male partners age(linear by linear association=59.94;P=.000).However,the percentage of chromosomal abnormalities in abortuses were slightly higher for the youngest male partner group aged 20-24 years compared to male partners aged 25-29 years(53.3%vs.45.4%).Univariate analyses showed that in comparison to the control group of male partners aged 25-29 years,the risk of chromosomal abnormality-related miscarriage was significantly higher in all other higher age male partner groups,namely,above 45 years(odds ratio=7.94;95%confidence interval,3.00-21.05;P<.001),40-44 years(odds ratio=4.82;95%confidence interval,2.90-8.00;P<.001),35-39 years(odds ratio=2.66;95%confidence interval,1.81-3.92;P<.001),and 30-34 years(odds ratio=1.45;95%confidence interval,1.02-2.05;P=.036).This effect of male partners aged more than 30 years was no longer apparent after adjustment for female partners age,female recipients BMI,male partners BMI,and semen parameters.Interestingly,after adjustment,the youngest group in our study(male partner aged 20-25 years)had 148%higher odds of having a chromosomally abnormal abortus compared with control group(adjusted odds ratio 2.48,95%confidence interval,1.03-5.96;P=.042).2.Effect of male partner body mass index on chromosomal aberration-related miscarriages.There were higher chromosomal aberration rates in miscarried fetuses for male partners BMI>25 kg/m2.Univariate logistic regression analyses showed that male partner BMI significantly correlated with the chromosomal abnormality-related miscarriage(P=.001).Furthermore,multivariate analyses showed that male partners with an elevated BMI(≥25 kg/m2)were at greater risk for chromosomal abnormality-related miscarriages compared to male partners with a lower BMI(adjusted odds ratio=1.56;95%confidence interval:1.14-2.14;P=.005).3.Effect of male partner sperm parameters on chromosomal aberration-related miscarriages.There were higher chromosomal aberration rates in miscarried fetuses for male partners semen volume<1.5 ml.Univariate logistic regression analyses showed that semen volume significantly correlated with the chromosomal abnormality-related miscarriage(P=.020).In addition,multivariate logistic regression analyses showed that male with semen volume<1.5 ml was a risk factor for abortus with chromosomal abnormalities compared with male with higher sperm volume(adjusted odds ratio=2.09;95%confidence interval,1.06-4.11;P=.034).Conclusions1.Male partner group aged 20-24 years shows slightly higher risk of abnormal chromosomes in the miscarried fetuses compared to male partners group aged 25-29 years,while the other male partners groups aged 30 years or older are not significantly correlated with chromosomally abnormal abortus.2.Elevated BMI of male partners is also associated with increased risk of chromosomal aberrations-related miscarriages.3.Decreased semen volume is associated with increased risk of chromosomal aberrations-related miscarriages. |
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