Paternal Age over 50 Years Affects ART Outcomes

Pavankumar Kamat


August 23, 2021


  • Paternal age >50 years was significantly associated with reduced chances of live births and clinical pregnancies following in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).

  • However, increasing paternal age did not affect the odds of miscarriage.

Why this matters

  • Poor outcomes of assisted reproductive technology (ART) with increasing paternal age emphasise the need for a public health message for men to avoid delaying fatherhood.

Study details

  • Findings are from a retrospective cohort study conducted at the Centre for Reproductive and Genetic Health (London, UK) including 4833 cycles of ART (IVF, n=2171; ICSI, n=2659) involving 4271 men.

  • Primary outcome: live birth rate.

  • Funding: None disclosed.

Key results

  • A significantly lower proportion of men who were older vs younger than 51 years met the World Health Organization semen analysis criteria (42.1% vs 61.1%; P=.001).

  • The live birth rate declined with increasing paternal age:

  • ≤35 years: 48.9% (95% CI, 46.2-51.5%);

  • 36-40 years: 41.0% (95% CI, 38.7-43.4%);

  • 41-45 years: 34.5% (95% CI, 31.7-37.4%);

  • 46-50 years: 31.8% (95% CI, 27.4-36.6%); and

  • ≥51 years: 29.5% (95% CI, 23.6-36.2%).

  • Compared with a paternal age of ≤35 years, paternal age of ≥51 years was significantly associated with lower odds of live birth (OR, 0.674; P=.021) and clinical pregnancy (OR, 0.643; P=.009), but not of miscarriage (OR, 0.678; P=.214).


  • Paternal health measures and causes of subfertility were not considered.

  • Retrospective design.


Morris G, Mavrelos D, Odia R, Viñals Gonzalez X, Cawood S, Yasmin E, Saab W, Serhal P, Seshadri S. Paternal age over 50 years decreases assisted reproductive technology (ART) success: A single UK center retrospective analysis. Acta Obstet Gynecol Scand. 2021 Aug 17 [Epub ahead of print]. doi: 10.1111/aogs.14221. PMID: 34405396.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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