Nowadays, many couples are delaying becoming parents until their mid 30s and beyond. This choice is not without conception consequences; data has been available for years about the adverse affect of advanced maternal age on childbearing. There is an increase in miscarriages and a decline in fertility rates, as well as increased incidences of chromosomal abnormalities in the first and second trimesters of pregnancy.
But what about advanced paternal age?
Recent evidence suggests that just as age affects female fertility, so can it affect male fertility. The following are common conditions and situations that older men may experience that inhibit their ability to impregnate their wives or partners:
1) Urologic disorders and prostate problems. While these conditions alone don’t necessarily impact fertility, the medicines prescribed can have a negative effect. When they enter the seminal fluid, the meds can be harmful to pregnant women.
2) Erectile dysfunction, loss of libido, and problems with ejaculation. All of these conditions inhibit sexual function and activity. Further, if relief entails surgical treatment, then it may lead to scarring and obstruction.
3) Cancers, such as bladder and prostate cancer. Treatment may lead to a lack of ejaculate, which means that surgery may be required to aspirate sperm from the testes. The only option in that case for insemination, then, is In Vitro Fertilization (IVF).
4) Testosterone supplementation. As men age, many complain of fatigue and are prescribed testosterone to improve mood, performance strength, and libido. Testosterone, however, depresses sperm count and should NEVER be prescribed to men trying to conceive. While doctors know this, frequently men take over the counter supplements or otherwise ingest testosterone unwittingly. What men should know is that the alternative to testosterone supplementation is exercise — this increases lean muscle mass and energy, while also providing a man with a sense of well-being and improved bone health. Rest and avoidance of stressful situations also helps.
5) Natural decreases in sperm count. As men age, research supports the idea that there are subtle declines in semen analyses over time. Semen volume decreases 0.3cc per year, and sperm motility decreases 0.7% per year. Progressive motility declines by 3% per year, and total motile count appears to decline 4.7% per year. Compared to men under the age of 25, adjusted odds ratio for conception within a 6-12 month period is as follows:
- 0.62 (age 30-34)
- 0.5 (age 35-39)
- 0.51 (age >40)
So the odds rate for conception within one year decreases by 3% annually. When intrauterine insemination data was analyzed, it revealed that pregnancy rates clearly declined with advancing paternal age. IVF data, however, is different, and there is no clear correlation between older men/advance paternal age and rates of fertility, implantation, pregnancy, miscarriage, and live births, and embryo quality in the early states.
Despite this reassuring news, with advancing paternal age there are also fewer blastocyst embryos. Also in donor egg cycles, there is a steady decrease in live birth rates, and an increase in spontaneous miscarriages. And intrauterine fetal death rates do appear to rise when the man is over 40 and over 50 — the odds ratio is 5.65 over 40, and 1.88 over 50.
Additionally, data shows that when the man is older there is a related increase in birth defects, fetal death, and stillbirth. There is also a notable increase in Caesarian sections, pregnancy-induced hypertension, preterm labor, placenta weight, and low birth weight infants. Experiments have shown there may also be greater DNA damage in sperm and increased incidences of rare disorders including imprinting and congenital malformation. Studies have shown more cleft lips and palates, complex disorders, and syndromes. There is even more childhood lymphoma and leukemia.
While most children born to older fathers are normal, the greater the paternal age, the greater the risk of issues related to fertility and conception. Just as it is with females, male peak fertility years are when they are in their 20s.
If you have concerns about the age of your male partner and your chances of conception, CONTACT US for more information.