Paternal Age and Fertility
How many times have you read, been told, or watched someone lecture about what happens to us Women as we age…especially to our fertility? Most fertility advice and treatment is directed at Women and what’s happening in our bodies. And while we women are used to shouldering all of the blame, men and advanced paternal age play a pretty sizable role in the fertility equation. Just because guys make sperm almost all of their life doesn’t mean that they can make a baby with this sperm. Here’s why…
Let’s start with a bit of basic biology…the process of sperm production in men is called spermatogenesis. Unlike oogenesis in females (the production of eggs), which occurs ONLY when you are a fetus inside of your mother’s womb (remember, a girl is born with ALL of the eggs she will ever make), spermatogenesis is like the Energizer Bunny—it keeps on ticking.
However, just like any device that is running on batteries, things can start to go awry over time. The situation is really not all that different with sperm. As men age, their sperm-production battery (a.k.a. spermatogenesis) starts to become more error prone. We see more breaks in DNA (the genetic material that is passed down to your future lineage) and a higher frequency of mutations within the DNA. These errors translate into abnormal sperm, which translates into abnormal embryos and infertility. Additionally, as men age, their semen volume decreases, sperm motility decreases, and the percent of normal sperm decreases.
Statistically, the average length of time it takes a couple to conceive when the male partner is older is longer than the time it takes a couple when the male partner is younger. The line in the “age” sand is debatable and usually set anywhere between 45 and 50. The same delay in conception appears to hold true even when doing IVF; older sperm will likely set you back (how much time is not clear).
There are also data to suggest that paternal age has a significant impact on how often a couple with an older partner not only has sex but also on sexual function. Studies show that older men have sex less often due to decreased sexual desire and diminished sexual function. Less sex is going to equal fewer chances of conceiving, no matter how good the sperm he still has.
Research has also shown us that advanced paternal age (again, think 45 or 50 years old) has an impact on specific genetic and medical conditions. These include autosomal dominant disorders (achondroplasia, Apert’s syndrome, Marfan syndrome, etc.) as well as schizophrenia, autism/autism spectrum disorder, and certain congenital anomalies. How or why these diseases or errors happen is not super clear. So far, scientists think the money is on a reduced amount of antioxidant enzymes hanging around in the semen. Think of these enzymes as the police; they are responsible for cleaning or stopping abnormalities. Just like a city without a good police department, the fewer enzymes, the more potential problems for the sperm and the resultant embryo.
Newer evidence also suggests that children born from older dads may have a SLIGHTLY higher chance of childhood cancers (specifically, leukemia and brain/nervous system tumors). Given these risks, most of us OB/GYNs will recommend chatting with a genetics counselor either before or in the very early stages of pregnancy. They can help break down even the most complex of issues and set the stage for what can happen when the curtain goes up.
When it comes to the Eastern medicine perspective, the battery analogy holds strong. Much of the fertility potential in Men (and Women for that matter) comes from the “Kidney Energy”, which is the deepest energy in the body and seen like a reserve or battery. The more you conserve Kidney energy by staying healthy (eating a diet that is appropriate for your particular body, exercising, getting adequate sleep, learning to manage stress through meditation, acupuncture, etc.), the more longevity one has and also, the higher the likelihood one can conceive in an advanced age. In the medical theory, it gets a bit more complicated than this, but suffice it to say, in addition to conserving this energy in diet and lifestyle, herbs and acupuncture that nourish the Kidney energy can often improve semen quality and mild erectile dysfunction.
And although we joked about it, this process is way stressful, and therefore, there is no need to blame, to point fingers, or to look for fault. Fertility is a two-way street. While we have let the guys off the hook when it comes to age in the past, we now know that paternal age does matter. It can most definitely play a role in infertility and abnormal pregnancies. This is important to remember when looking for the cause of infertility.