Impact of male partner’s age on IVF/ICSI pregnancy outcomes stratified by female age: a retrospective study of 1,703 treatment cycles

Increasing male age has been linked to reduced sperm quality and poorer pregnancy outcomes in assisted reproductive technolo (ART) cycles; however, the combined effects of both paternal and maternal ages remain controversial. A retrospective analysis of 1703 fresh embryo transfer cycles (January 2018–June 2024) was conducted. Females were stratified into 0.05). Although age 35 in males appeared to be a potential inflection point for changes in reproductive outcomes, comparative analysis revealed no statistically significant differences in pregnancy outcomes between men 0.05). Further analysis revealed that advanced male age was associated with significantly higher DFI abnormality rates. The high-DFI group showed increased biochemical pregnancy loss (11.7% vs. 5.2%) and miscarriage rates (38.0% vs. 20.9%), with significantly elevated DFI levels in the miscarriage group versus non-miscarriage group ( P = 0.030). However, DFI showed no significant correlation with embryo quality parameters or clinical pregnancy rate. This retrospective analysis demonstrates that the impact of male age on IVF/ICSI outcomes is dependent on the female partner’s age. Specifically, male age is not significantly correlated with clinical outcomes when the female partner is under 35 years; however, among female age ≥ 35 years, advanced male age is associated with increased miscarriage rates and decreased live birth rates. Sperm DNA damage may contribute to these adverse outcomes observed in older female partners. Therefore, careful evaluation and management of sperm DNA integrity should be prioritized in clinical practice.