As couples plan their journey towards parenthood, discussions about fertility often focus primarily on the woman's age however, it is crucial to recognise that male age also plays a significant role in reproductive success. In recent years, research has shed light on how advancing age affects sperm quality and fertility outcomes in men.

We all know, there is a lot of information and awareness in our society about female age and fertility, to the extent that once a girl achieves puberty somewhere, it is drilled into her mind that she must get married and quickly have a child but we hardly speak about men’s age and fertility. In an interview with HT Lifestyle, Dr Manju Nair, Clinical Director - Fertility at Cloudnine Group of Hospitals in Bengaluru's Old Airport Road, explained, “Sperm quality encompasses various factors such as sperm count, motility (the ability of sperm to move effectively), morphology (the shape and size of sperm) and DNA integrity. While men produce sperm throughout their lives, the quality of sperm tends to decline with age.”

She elaborated, “Like female fertility, even male fertility changes with advanced age, though for men it’s always a slower decline. Aging can affect the quality of their sperm, including motility, morphology, and concentration, which makes it difficult to fertilize an egg. At present in men, fertility starts to decline in their late 40’s. One study suggested that conceiving during 12 months was 30% less likely for men who are over the age of 40 as compared to men under 30 years old. Though the effect of advanced paternal age was more about natural conception, varying studies have also shown that it had a negative impact on the success of assisted reproductive treatment as well.”

What causes and effects the decline of sperm quality?

Dr Manju Nair revealed -

• One of the primary factors contributing to age-related changes in sperm quality is an increase in DNA damage. As men age, the frequency of genetic mutations in sperm cells rises, leading to an elevated risk of chromosomal abnormalities in offspring. These mutations can result in conditions such as Down syndrome and autism spectrum disorders, highlighting the importance of considering paternal age in discussions about reproductive health.
• Other related issues may arise with age, like genetic abnormalities in sperm, reduced libido, and erectile dysfunction. And mostly, they remain asymptomatic, with only the inability to conceive even after trying for a long time.
• Moreover, advanced paternal age has been associated with a decline in sperm count and motility. Studies have shown that older men tend to have lower sperm counts and reduced sperm motility compared to younger counterparts.
• This decline in sperm quantity and quality can lead to difficulties in achieving conception and may increase the time taken to conceive.
• Furthermore, advancing age in men has been linked to an increased risk of infertility and pregnancy complications. Couples where the male partner is older may experience longer times to pregnancy and higher rates of miscarriage.
• Additionally, older fathers have been associated with an elevated risk of pregnancy complications such as preterm birth, low birth weight, and gestational diabetes. Advanced paternal age was also associated with an increased risk of miscarriages. And the influence of male age was more pronounced when the female partner also had advanced age.
• Age-related changes in hormone levels, particularly testosterone, may impact sperm production and function. Testosterone levels typically decline with age, which can affect sperm production and contribute to declines in sperm quality and quantity.
• Advanced paternal age has also been associated with poor offspring health, with an increased risk of childhood cancer, neurocognitive disorders, and genetic abnormalities.

What next?

While the impact of male age on fertility is significant, there are steps men can take to optimise their reproductive health as they age. Dr Manju Nair said, “There are various interventions available, even for older men, for those facing fertility issues. Some of them include lifestyle modifications, antioxidant foods, medical management with hormones to take care of hormone imbalances, sperm extraction procedures with poor sperm concentration, and elevated DNA fragmentation index.” She suggested -

• Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and avoiding tobacco and excessive alcohol consumption, can help mitigate age-related declines in sperm quality.
• Additionally, seeking timely medical evaluation and treatment for any underlying health conditions that may affect fertility is crucial.

Dr Manju Nair concluded, “These advancements in the diagnosis and treatment of male fertility are very relevant in the modern age, where, because of socioeconomic factors, couples are choosing to have children at older ages as compared to previous generations. In conclusion, male age plays a crucial role in sperm quality and reproductive success. As men age, they may experience declines in sperm count, motility, and DNA integrity, which can impact fertility outcomes and increase the risk of pregnancy complications. With the advancement of technology, assisted methods, and celebrity endorsements, egg freezing and embryo freezing are a lot more advanced these days.”

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