“Infertility is not just for women, because the biological clock is for both women and men. There is no one to blame for, but being aware of this concept is everyone’s responsibility.” – Dr Nisha Bhatnagar.
It’s been decades, and there is a conversational gap between age and fertility because it always rounds back to women, and their biological clock, egg quality, declining ovarian reserve, and reproductive health concerns. But very few talk about male fertility, the age factor. This shows the large gap in public awareness about male fertility and how it changes with age.
It is important to note that men are not immune, and with age, their reproductive health also declines. Meaning, fertility does not discriminate by gender; it affects both males and females equally.
This article will help you to know about male fertility after 35, 40 and 45, and what changes happen.
Spermatogenesis is a process that begins with spermatogonial stem cells (SCC), which are divided into stages called spermatogonia, primary spermatocytes, secondary spermatocytes, spermatids, and spermatozoa (fully matured form). The whole cycle takes nearly 90 days from stem cell division to a sperm (one that is capable of fertilisation). Out of these 90 days, roughly 12 to 21 days revolve around the process of maturation in the epididymis. This is one of the reasons that, like women’s menopause, men do not face a sudden drop in reproductive health, unless they are not exposed to toxins, heat, oxidative assault, or have injuries.
After 40, the conception chances of men are reduced by 30% to 40% than men younger than 30. Lifestyle and environmental factors play a major role in fertility, along with age. It is obvious that, through age, the quality and quantity of sperm decrease, and it plays major role in fertility. Let’s understand how ageing actually impacts fertility.
Andropause- Declining testosterone and its impact on sperm production; Not like women, but men do face a hormonal shift as well. Not that dramatic, after 30’s their testosterone started to decline throughout their lives. This process is called androause, which plays a significant role in male infertility.
This is the age when most of the men experience subtle changes in their reproductive health. Some experience no issue in conceiving, while some face dramatic issues. Let’s understand one by one.
As the age increases, ROS (reactive oxidative stress) increases in the reproductive system. These are free radicals that ultimately attack the sperm membrane and damage their DNA. Also, every time a sperm is produced, it undergoes a process of cell division and DNA packaging. If the error happens in the process (mostly due to oxidative stress), it results in damaged or broken sperm genetic material. It is also responsible for miscarriages, childhood development conditions, failed fertilisation, or poor embryo development. In short, the enzymes responsible for repairing DNA nicks during spermatogenesis become less effective, leading to DNA fragmentation.
Rather than abruptly, the quality of sperm gradually decreases, which covers movement, DNA, shape, size, semen volume, and also hormonal status. Due to the shrunken testicles, they become less responsive, leading to decreased sperm production efficacy. Along with several things like environment, lifestyle, and habits, it is highly influenced by this. Several studies also revealed that, after 35, the swimming speed of sperm and forward progression has decreased compared to men in their 20’s. Morphology also begins to fall, which means that a greater number of sperm are unable to penetrate an egg even if they reach it.
Andropause or late-onset hypogonadism starts once a man crosses 35. It is a clinical syndrome where a man’s testosterone level gradually decreases with age, and its symptoms include erectile dysfunction, fatigue, reduced libido, and loss of muscle mass. Not every man faces a similar issue,
Just like women, men reach their peak fertility in their 20’s. That is why, if a couple in their 20’s is able to conceive a child within 4 to 5 months of trying, that same couple might not be able to conceive for 2 years if they are in their late 30’s.
Bottom line for men at 35- Yes, you are highly fertile, but the trajectory has begun. This is an excellent window to get a baseline semen analysis and make effective lifestyle adjustments. Because you obviously don’t want to ruin your reproductive health, right?
By 40, total sperm count and semen volume decline steeply by 20 to 25 percent compared to men in their 30’s. This happens because of the natural human cycle. Around 46% of men in India aged between 35 and 50 are dealing with some health condition, including 33% of men experiencing depression, and 50% of men over 40 have some degree of erectile dysfunction, which contributes to leading towards infertility.
Women are definitely born with limited eggs, but men constantly create new sperm cells, which further divide and replicate every 16 days. By the age of 20, the sperm have gone through more than 150 divisions, and by 50, more than 800 divisions. But, listen carefully, the more sperm are replicated, the more chances of a genetic mutation happening. Most of the time, they are benign, and they won’t cause any issues for the baby.
Also, in the 20s, men pass only 25 new genetic mutations, but by 40, it leads to 65 mutations, and these are directly linked with the risk of conditions like autism spectrum disorder, schongroplasia, schizophrenia, or other childhood cancers- as per studies.
After 40’s, a drop in testosterone becomes noticeable, as their libido reduces, more fatigue, abdominal fat increases with decreased muscle mass, and their body hair reduces. But erectile dysfunction in particular becomes more common, and this is most commonly experienced by men to some degree. As testosterone drops, it also impacts their sexual satisfaction, which makes difficulty in couple to become parents.
Note to all men- You must be started to have difficulty to become parent, and all these are because you are slowly moving towards ageing, and your reproductive health is also having problems.
Some men in 40’s still able to father a child, but as their age reaches 45, their biological obstacles become more significant, and this points out the importance of proactive health management practices.
By the passing age, the risk of genetic and developmental conditions increases, and this appears due to the accumulation of de novo mutations (new genetic errors) in sperm. As we talked earlier, it happens due to the division of sperm, and the more divisions that happen, the number of risk increases. The most shocking fact is, a man who fathered children in their 45 have 3.5 times higher risks of genetic issues in their children than a man who fathered children in 20’s. Schizophrenia, bipolar disorder, and certain congenital abnormalities are some of the common challenges.
We all know how hormones play a role, and by this age, declining hormones intersect with other aspects of metabolic health, including cardiovascular diseases, obesity, and even insulin resistance. Low testosterone promotes obesity and metabolic dysfunction, and gradually lowers the sperm count, because obese men are likely to have 42% less sperm count than others.
Medically, ART (Assisted Reproductive Technologies) such as IVF (In-Vitro Fertilisation), or ICSI (Intracytoplasmic Sperm Injection) are some of the treatments that help couples to become parents even after several challenges. But, it also has some boundaries, and biological age can surpass these challenges, but to some extent. Men above 45 have 43% higher risk of miscarriage, and it significantly impact on the IVF procedure also.
Key distinction- Not just for you, but now fathering a child means you are risking your baby to have a chromosomal or genetic mutation condition. The probability is somewhat low, but you cannot neglect the chances.
For your clarity, offspring health refers to the mental, developmental, and physical health of a child, which is shaped by the parental lifestyle, environment, and health before and during pregnancy. Not just mothers’ but fathers’ health affects children directly. Studies often indicate that children of father age above 40 are 2-3 times more likely to develop issues like Autism spectrum disorder, while 13 fold increased risk of ADHD.
There is a direct link between advanced paternal age and risk of autism spectrum disorder in children. Studies also supported the fact with the conclusion that the risk of ASD in parental age increased 40% and 50%. Even men aged 35 have a risk ability with 20%, which indicates the possibility of a higher risk with higher age.
Several genes implicated in ASD, including those involved in synaptic development and neural connectivity, are known as mutation hotspots. That means, they are more susceptible to genetic mutation than others.
It is a chronic, severe brain disorder that impacts the ability to think and behave, and it is usually detected in late teen years to early thirties. So in childhood, you might think that your child is normal, but as they age, your choice to become parents at a later age impacts your child. It is rare to detect this condition before age 13.
This condition happens because of the accumulation of de novo mutations in sperm cells, and this started to happen in men over 35 and can become three times riskier by the age of 50. Due to obesity, poor diet, lack of exercise, and age, DNA mutations accumulate as men age.
Apart from that, let’s understand the possibility of other conditions linked with paternal age.
An important thing that need to keep in mind is that male fertility is highly responsive to environmental factors, medical interventions, and lifestyle. So, you’d better be more proactive when it comes to life choices.
Not because of age, but everyone should eat antioxidants and a protein-rich diet, as it protects sperm DNA from oxidative damage. Fruits, vegetables, legumes, fish, olive oil, and whole grains help in ensuring the parameters of sperm, and this has been backed by multiple studies. Most importantly, it is best to avoid eating processed food, refined sugar, trans fats, smoking, and drinking, as these are associated with chemical which can lower the quality of sperm.
Production of testosterone peaks during the time of sleep stages, and even one week of chronic sleep deprivation can reduce the testosterone level by 10 to 15% in young men. Even doctors recommend sleeping for 7 to 8 hours to make sure that the body recovers and your hormones are balanced. One of the main reasons behind improving cortisol level as this force body to prioritise body mobilisation over reproduction, reducing Leydig cell function in the testes.
Obesity is particularly visceral adiposity, which impairs male fertility by creating issues like hormonal imbalance, decreased sperm quality, and increasing inflammation in the body. Adipose tissue converts the testosterone to oestrogen via aromatase enzymes, and increases the temperature os scrotal. By reducing body weight, men can easily improve the quality of semen by 5% to 10%. Also, those who consume alcohol frequently tend to have a lower fat-burning tendency and have increased appetite, which also leads to obesity. So, it is better to have a clean diet and indulge in activity to maintain a BMI level.
Men over 35 should ensure to take tests once to know about their reproductive health. Through this, you will be able to know about your reproductive health, but one thing you need to keep in mind is that don’t rely on one test. Sperm quality fluctuates based on your lifestyle, environment, and other factors. There is a possibility that one month your results are not good, but next month, due to a healthy and stress-free lifestyle shows a good number in your semen analysis test. So, always go for at least 2 to 3 tests to ensure your semen analysis report.
Although the risk factor is very low, it is always safe to know what is happening in your body. Aveya Fertility Centre encourages men to take care of their reproductive health just as women do. Because they don’t have an endless supply of sperm. After a certain point, their fertility also decreases, so it is better to analyse their health and consult with an expert from time to time.
As of now, you must be aware of the changes that your body experience by the age. By this, the semen analysis test should be your priority, along with consulting with an expert. And if you’re still considering delaying becoming a father, then it is best to talk to the fertility expert about the sperm freezing process. Because, after a point, your sperm will create issues in treatments like IVF, and you obviously don’t want your child to be born with some health issues.
At this age, the sperm quality and quantity rapidly decline, and this also increases the chances of DNA fragmentation, which can lead to infertility, a baby born with issues like dwarfism, etc. Also, if a man has a family history of fertility-related or genetic issues, they should not delay consulting with a fertility expert.
Male fertility changes with age, and yes, they also have a biological clock. Testosterone decline, sperm quality becomes questionable, and quantity leads to a stage where quality sperm is hard to define. It is not fear you about your fertility, but science argues strongly, because awareness and proactive steps should be taken on time.
Aveya Fertility Centre is working tirelessly to ensure that men and women are able to become parents without questioning their ability, because through timely precaution and right treatment options, the possibility is high. So, if you are someone who is still thinking about visiting an expert, don’t delay, and book your consultation.