Impact of paternal age in donor oocyte cycles: An Artificial Intelligence-Based Analysis

Purpose To determine whether artificial intelligence (AI) can detect the impact of advanced paternal age (APA) on embryonic development and, consequently, on assisted reproductive technology (ART) outcomes. Methods This retrospective observational study analyzed medical records from the VRepro database (April 2022–October 2023) at a single fertility center. To minimize the confounding effect of oocyte age, only oocyte donation cycles were included, and to control for the influence of semen quality, only normozoospermic samples were analyzed. All cycles underwent intracytoplasmic sperm injection (ICSI). Patients were categorized into two groups: men < 45 years (Group A) and men ≥ 45 years (Group B). Embryo development was assessed through conventional parameters, morphokinetics, and AI-based scoring. Results Fertilization rates, blastocyst formation, and embryo quality according to ASEBIR criteria were comparable between groups, with no significant differences in morphokinetic parameters. However, median AI-based embryo scores were significantly higher in Group A than in Group B, suggesting lower implantation potential in embryos derived from older men. Although live birth rates per transfer were similar, Group B showed a reduced proportion of live births per implanted embryo. Conclusion APA may adversely affect embryo quality and compromise reproductive potential, even among normozoospermic men. These findings support the use of AI-based embryo evaluation to complement ICSI in cycles involving older male partners and highlight fertility preservation as a potential strategy for mitigating age-related reproductive decline in men.