Declining Fertility with Age in Men
Declining fertility with age is not just a female issue. We all know about the increased risks of infertility or birth defects in older women who want to have a child, and are aware that these risks are due to chromosome changes in the egg that occur as women age.
However, as with most things reproductive, the medical community has lagged far behind in evaluating the effect of aging in men on sperm quality. Several recent studies have begun to paint a picture of aging of the male reproductive tract which is very similar to that seen in women.
Specifically, in a study of 2,000 couples (Hassan & Killick, Fertility & Sterility; June, 2003) men that were over 45 years of age had a five-fold increase in time to pregnancy for their partners (how long it took them to become pregnant) as compared to younger men. This effect was seen even after taking into account the variables of their wife’s age, how often they had intercourse and whether or not they had fertility adverse life styles (smoking, drinking etc..). Even older men who had very young wives (<25 yrs of age) had a four-fold increase in time to pregnancy.
In this study, 57% of these 2,000 unselected couples became pregnant within 3 months of trying to conceive, and 81% after 1 year. The average time to pregnancy increased from 7 months in men that were 25 years of age or younger, to 37 months in men that were over 45 years of age.
Other work suggests that similar to the changes seen in women, these delays in fertility may be due to DNA or chromosomal abnormalities in the sperm of older men. Singh et al (Fertility & Sterility, Dec 2003) found that the DNA of sperm in men ages 36-57 had far more breakage in the strands than did sperm from men ages 20-35. These strand breaks have been associated with infertility, early embryo losses, miscarriages and even birth defects or cancer in children.
Another study (Sloter et al., Fertility & Sterility April, 2004) also showed age related increases in the number of sperm with broken or damaged DNA for men, especially sperm with structural chromosomal abnormalities. This study suggested that these changes may be due to environmental toxin damage, or a loss of internal antioxidants in semen in aging individuals.
What can be done to help the chances of conceiving for older men?
Be sure and have a sperm chromatin assay done in addition to a normal semen analysis (visit http://www.scsadiagnostics.com/ to learn more), so that you know if sperm DNA damage is present. I highly recommend this test for older men, especially because many older “dads-to-be” are on medications which may cause DNA strand breaks (e.g. antidepressants, cholesterol lowering drugs etc…).
When providing a semen sample for testing or for clinical procedures, use Pre~Seed as a sperm-friendly lubricant to help make semen sample collection more pleasant. This is important because the more enjoyable ejaculation is, the more normal sperm a man can produce for these samples!
There is also a growing body of evidence that vitamins with antioxidants help men with low fertility. Numerous studies have found that infertile men do not make enough of their own antioxidants in their semen to protect sperm on their journey at ejaculation and through the cervix. INGfertility did a study on FertilAid vitamins and found that this antioxidant containing fertility vitamin increased total motile sperm counts for some men. I do recommend that all TTC men take a fertility vitamins while TTC.
Make sure you have intercourse timed with ovulation to optimize the chances of sperm and egg meeting. Ovulation prediction tests, as well as tracking cervical mucus quality are effective ways to know when to get busy “baby-making”. Having intercourse every other day during your fertile window, up to your first day of “dry” (or less) cervical mucus, will make sure you cover the bases.
Vaginal dryness and a lack of secretions during your fertile window makes intercourse uncomfortable and can interfere with fertility. Supplementing your secretions with Pre~Seed makes “baby-making” more fun. Better feeling intercourse can increase sperm production! So take that time for at least one session during your fertile window to have “Gourmet Sex”—the long, relaxed, “we love each other” kind!
Blessings~ Dr. E
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