Updated: July 17, 2018 10:13:22 am
A male’s age can impact fertility in many ways. The risk of birth defects is also higher in children born to elderly men.
By Dr Meenakshi Dua
Decline in fertility with age is always thought to be a female problem, whereas men have been documented in scientific literature as retaining their fertility till an advanced age of 94.20. These days, couples often delay parenthood till they are more established in their careers and economically more stable to rear children. Also, many men tend to start a second family later in life.
Since 1980, the fertility rate for men in their 30s has increased by 21 per cent and for men aged above 40 years, the rate has increased nearly 30 per cent. In contrast, the fertility rate in men younger than age 30 years has decreased by 15 per cent. Thus, paternal age is rising.
INCREASED CONCEPTION TIME
A male’s age can impact fertility in many ways. Firstly, the older a man is, the longer time he takes to conceive his first child. Studies have shown that increasing male age is associated with increased time to conception. This happens because of decline in sperm count, morphology and motility with advancing age. However, the exact reason for this is not understood except for deterioration in testicular histological architecture.
Secondly, there is age-related increase in acquired medical conditions, such as diabetes, hypertension, hypercholesterolemia which directly or indirectly affects semen quality and sperm DNA. Diseases per se and medications used to control them have a documented negative impact on semen parameters. Recent studies have shown that single gene de-novo mutations in offspring double with each passing year. This leads to abnormal pregnancies and repeated miscarriages.
DECREASED SEXUAL ACTIVITY
Thirdly, apart from semen parameters, aging also affects coital frequency and sexual functioning which can increase time to pregnancy. Decreased sexual activity can decrease the chances of conception, and erectile dysfunction (ED) increases with age. This all can add to the problem of infertility.
LINKED TO BIRTH DEFECTS
Last but not the least, advanced paternal age has been linked with neurocognitive disorders such as autism and schizophrenia and various birth defects. A 2011 Meta analysis on autism clearly showed that autistic children were two times higher in fathers aged over 50 years. This same study found that men over 30 years were more likely to conceive a child with schizophrenia, greatest risk being at age 50. Other psychiatric disorders like bipolar is also found to higher in children fathered by men over 55 years of age.
The risk of birth defects is higher in children born to elderly men. A study evaluating over 4000 Down’s Syndrome babies showed that age of the father was a strong factor in 50 per cent of cases. A Danish study involving over a million births found that paternal age is a risk factor for cleft lip and palate, independent of maternal age.
To conclude, a man’s age does affect his fertility. It is associated with longer time to conception, decreased sperm quality, increased sperm DNA abnormalities, increased risk of miscarriages and birth defects and lastly, increased risk of neurocognitive disorders. Various ART techniques are available to combat low sperm count, motility and high DNA fragmentation. They can help couples conceive and enjoy parenthood. However, changes due to advanced age cannot be reversed. There is no medical cure for this. These couples have to resort to IVF/ICSI to enjoy parenthood. Finally, time waits for none. According to recent CDC data, most fertile age for men is between 25 to 29 years. It’s always better to act on time.
(The writer is Lead Consultant, IVF & Fertility, The CK Birla Hospital for Women Gurgaon.)
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