Business Day (Nigeria)

For men too, age is a barrier to fertility

- ABAYOMI AJAYI, MD/CEO Nordica Fertility CENTREINFO@ABAYOMIAJA­YI. COM.NG, Note: The rest of this article continues in the online edition of Business Day @https:// businessda­yonline.com/

When it comes to infertilit­y, a man’s age does matter. While you may not have a complete drop off in fertility like a woman, advanced paternal age is something that couples should be aware of. As a rule of thumb, a man and a woman must both contend with their biological clocks.

It is well known that it becomes much more difficult for a woman to become pregnant as she gets older but a man also has fertility issues with ageing. However, this isn’t stopping you from having children later in life.

As a man you typically have changes in semen quality as you get older. Issues such as your sperm concentrat­ion, motility, and morphology all typically decrease over time. This is partly caused by your natural decline in testostero­ne levels.

On the average, testostero­ne dips by 1-2 percent per year once you hit age 30. Since testostero­ne plays such a strong role in spermatoge­nesis, it makes sense that sperm quality would see a similar decline.

Sperm DNA integrity tends to decline with age. Older men tend to have higher levels of DNA fragmentat­ion which can lead not only to fertility difficulti­es, but also to higher rates of newborn birth defects. Advanced paternal age (older men having children) has been correlated with a slightly increased risk of birth defects, autism, cancer, and schizophre­nia.

As couples age, they are also more likely to partake in decreased levels of sexual activity, which is directly correlated with decreased chances of conception. The chance of Erectile Dysfunctio­n (ED) also increases with age, though ED is typically not associated with the frequency of sex.

As a man you start to contribute to reduced fertility in your 40s. While your sperm quality doesn’t decline as quickly as a woman’s egg quality, it does drop and it can take you as an older man, longer to impregnate your wife than if you were younger.

If you are a man pursuing fertility treatment, the risk of not having a baby after IVF is more than five times higher at 41 years old or older. Note that children fathered by men older than 40 are more than five times as likely to have an autism spectrum disorder than those fathered by men under 30.

Like it or not, for a man and a woman, age is a barrier when it comes to starting a family, and the first step to making sure that you can become a father is understand­ing what the risks and rewards are to have a child at any age.

It is no longer a secret that male fertility generally starts to reduce around age 40 to 45 years when sperm quality decreases. Increasing male age reduces the overall chances of pregnancy and increases time to pregnancy.

Although it is well-establishe­d that women are most fertile before 40 years, for men, there is an age-related decrease in the overall volume of semen, the total number of sperm, typical sperm morphology, and sperm motility in addition to an increase in the fragmentat­ion of DNA.

For instance, the number of motile sperm and overall sperm count begin to decline after 34 years while the number of sperm with typical morphology and concentrat­ion decrease after 40 years of age.

The underlying mechanisms of the age-related decrease in male fertility are not currently well known. It is hypothesiz­ed that such changes may be due to the increased risk of damage to the reproducti­ve system resulting from infections or smoking due to age, reduced tissue and cellular repair of damage due to toxin or disease exposure, or due to the normal changes that occur within the reproducti­ve system as individual­s’ age.

As you age, your testes are subject to age-related structural changes even as the levels of total and free testostero­ne, the primary male sex hormone, decrease in line with age, increasing in the dysfunctio­nal activity of the testes.

Most male infertilit­y is associated with poor-quality semen, which can be caused by a variety of reasons ranging from having abnormally shaped sperm, sperm that do not move correctly, and having a low sperm count.

Several other factors are attributed to male infertilit­y. If you are trying to get pregnant as a couple, being aware of some factors and making changes where appropriat­e may improve your chances of conceiving.

Specific recreation­al drugs have been found to reduce the quality of sperm and consequent­ly reduce fertility. While trying to get pregnant, avoid taking drugs like anabolic steroids, amphetamin­es and other addictive drugs.

Even cigarette smoking is not advised because it can have both a negative effect on the ability to conceive and on a newborn baby’s health. Smoking while trying to conceive can reduce fertility, and exposing a newborn baby to cigarette smoke is associated with an increased risk of sudden infant death syndrome and respirator­y disease.

If you have heard that the temperatur­e of the testicles can also affect fertility, there is some truth in it. The testicles are located outside the body because they need to be around 34.5 °C compared to the rest of the body’s optimum temperatur­e of 37 °C to produce the best quality sperm.

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