What impact does aging have on male fertility?

Posted by & filed under Aging, Sperm, The Basics.

Getting older has its advantages. But many men over 45 worry about the impact their age will have on the quality of their sperm, and the health of children they may be responsible for.

Sometimes, these are valid concerns. But there are things you can do about it.

1. Get a sperm test with DNA fragmentation. Women may not be able to confirm their egg quality until they complete an IVF cycle, but for men it’s much more straightforward.

2. If you have sperm quality worries, it may be appropriate to introduce lifestyle changes and vitamin therapy.

3. Get further testing done. Your testosterone levels can be checked with a simple blood test. Low testosterone levels can often be treated successfully with Clomid or Arimidex. You can also check for varicoceles, dilated veins that heat the testes. They can be found with a physical exam or scrotal ultrasound, and treated through minimally invasive surgery with faster recovery times than in the past.

4. Talk to your doctor to find out if Viagra or Cialis is right for you. You may not need these in other sexual encounters, but procreational intercourse can be quite stressful. If you worry that you can’t have an erection with timed intercourse, it’s okay.

Another option is intrauterine insemination. You might find it easier to just let your sex life be your sex life, and procreation can take the form of providing sperm samples in the morning for the clinic to inseminate later that day. In the event you’re unable to provide a sample one day, frozen sperm is available as a backup. This lessens some of the pressure to have procreational sex.

5. Take your overall health seriously. Some men worry that their ejaculate has less volume than it did when they were younger. In many cases, this can be addressed through better hydration. A volume drop may be related to other health concerns, such as retrograde ejaculation (ejaculate travels backward into the bladder rather than out the tip of the penis). Take care of your overall health by having frank discussions with your doctor.

Now and again, men are concerned they don’t “shoot” as far. Well, it does happen with age. Let me reassure you, there’s absolutely no proof that it makes any difference to anything whatsoever.

I don’t think the distance the ejaculate moves is as important as volume, which is necessary to protect the sperm with seminal fluids while they find their way out of the acidic vagina, into the cervical mucus, and ultimately up into the uterine cavity.

6. Do IVF with ICSI. Intracytoplasmic sperm injection (ICSI) will ensure eggs will be fertilized. Newer techniques in the lab have been shown to be associated with lower DNA fragmentation rates, rather than higher. That’s right! It’s possible the modern techniques are better able to sort out the “best sperm” than nature alone.

 

The only real problem with IVF is the expense. I don’t mean to minimize it – expense is a very real stress for most couples – but so can be the month-in/month-out lack of success for pregnancy and the strain of a sexual act that can make you feel further away from your partner, rather than bringing you closer.

In our clinic, we strongly recommend that couples consider IVF after all other reasonable options have been exhausted over a five month period. Fertility treatment can take an emotional toll on a couple, and we want to see you move past the hopeful phase and into the pregnant phase as quickly as possible.

The science behind paternal aging and how it may affect the health of children is interesting and changing all the time. (At least, it’s interesting to us.) If you want to know more, please let us know in the comments. I will be very happy to expand this section further.

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