At what age should men be concerned about their fertility? Some studies say over 40 but most agree that men over 50 years of age need to be concerned.
First, it’s important to remember that, unlike women who see both egg quality and quantity decline with increasing age (more rapidly after the age of 37), men tend to maintain sperm quantity but see a decline in sperm quality. Specifically, a decline in sperm motility and sperm shape (aka morphology) with increasing age.
The real question is: What impact does age have on my (and my partner’s) ability to have a child? And this is where it gets confusing… We know that as a man ages, the time to pregnancy increases and pregnancy rates are lower. It was shown in a study of men 45 and older with young partners (<25) that couples were 5X more likely to take > 1 year to conceive. Two other studies showed that men fertilizing younger, donor eggs successfully fathered children 41.3 % of the time if they were over 50 vs. 56% of the time if under 50 years of age. However, a more recent study, while showing a decrease in fertilization rate with older sperm, showed no difference in live birth outcome. And there are studies that claim there is no relationship between advanced age of the male and fertility!
Age can affect sperm motility and shape: It is commonly accepted that as a male’s age increases his sperm shape and motility can be affected. This is not true in every case but it can impact the time required to get pregnant when the man is older and the couple is trying to conceive naturally with a younger female partner.
Understand what you are potentially facing: To understand where you are and what you might be facing, men over 40 should consider checking their sperm with a reliable home kit like the YO Home Sperm Test, which assess motility or, alternatively obtaining a formal semen analysis through their physician.
What about fertility treatment? If the female partner is < 36 years old, it bodes well for a more positive outcome because better egg quality or ICSI can help overcome the problems with aging sperm in men >40. The decision to proceed with fertility treatment is highly personal and should be discussed with your fertility physician.
What I tell my patients: When it comes to fertility treatment, I generally tell men over 40 that there may be some concern with their semen parameters declining, but overall the age of the egg still drives the overall success rate of fertility treatments.
What about genetics, pregnancy risks and the offspring? Couples should also be aware of “possible” genetic and pregnancy risks of the offspring. I will focus on this topic in Part 2 of our Male Aging and Fertility series. Does Male age increase risk to the pregnancy and Baby?