Male Fertility With Age
Where women experience a more sudden change in fertility
as they age, the decline of male fertility is a gradual
process, commonly known as andropause.
The main age related changes in the male reproductive
system occur primarily in the testes. Testicular tissue
mass decreases and the level of the male sex hormone
testosterone starts to decline. This may lead to problems
with erectile function and fertility.
Reproductive system changes are closely related to
changes in the urinary system, so when we look at physiological
changes in the male with age, we include both systems:
- The tubes that carry sperm become less elastic,
termed sclerosis.
- The testes continue to produce sperm, but the rate
of sperm cell production slows.
- The epididymis, seminal vesicles, and prostate
gland lose some of their surface cells but continue
to produce the fluid that helps carry sperm. The volume
of fluid ejaculated usually remains the same, but
there are fewer living sperm in the fluid.
Conditions Of The Prostate & Renal System With
Aging
The prostate gland enlarges with age as some prostate
tissue is replaced with a scarlike fibrotic tissue.
This condition is known as benign prostatic hypertrophy
(BPH) and affects about 50% of men. If the enlarged
prostate partially blocks the tube that drains the urinary
bladder [urethra], this may cause problems with urination
as well as with ejaculation. Fertility is not affected
by prostate function .
Changes in the prostate gland can also predispose elderly
men to urinary tract infections.
Renal reflux, where the urine backs up into the kidneys
may develop if the bladder is inadequately drained,
which if left untreated, may result in kidney failure.
Prostate gland infections or inflammation (various
forms of prostatitis) may also occur.
Prostate cancer becomes more common as men age. It
is one of the most frequent causes of cancer death for
men. Bladder cancer is also a common cancer in older
men. Testicular cancers are possible, but these more
often occur in younger men.
Sexual Performance With Aging
Changes in sexual performance may result from decreased
testosterone level or from psychological and/or social
changes related to aging such as relationship issues,
chronic conditions or medications.
- Decreases in the sex drive [libido] may occur for
some men.
- Sexual responses may become slower and less intense.
- Erectile dysfunction - erections may occur less
frequently, and aging men often have less ability
to experience repeated ejaculation. 90% of erectile
dysfunction is believed to be of medical rather than
psychological origin.
- Medications used to treat hypertension, stress
or depression can cause some men problems in developing
or maintain an erection sufficient for intercourse.
- Chronic disorders such as diabetes can also cause
erectile dysfunction.
Effects of Age on Male Fertility
Men are not as aware of the effect of age on fertility
as women are. Many refuse to accept that their fertility
declines with age, yet studies show that the chances of
a men fathering a successful pregnancy decline by 11%
every year. Source: 2004 issue of the
American Journal of Gynecology.
Much of male fertility with age relates to aging sperm.
Sperm volume, motility, and structure of sperm all decline
with age. Source: 2004 issue of Human
Reproduction Update.
Further, a mans contribution to normal reproduction
does not end with fertilization. There is a significant
impact of aging sperm on birth outcome.
The risk associated with women past their mid thirties
having a child with a genetic abnormality increases
sharply. When both parents are over 35 at the time of
conception Downs Syndrome is related to sperm approximately
50% of the time. Source: June 2003
issue of The Journal of Urology.
Men age 40 and older have a six-fold greater risk
of having children with autism spectrum disorders compared
to those under 30 years. The age of the mother is not
a factor in this birth condition. Source:
September issue of Archives of General Psychiatry.
Men between the ages of 45 to 49 were twice as likely
to have children with schizophrenia as men 25 and younger.
The risk triples for men over the age of 50. Source:
2001 Archives of General Psychiatry
Prevention And Treatment
Certain physical age-related changes in men, such
as prostate enlargement or testicular atrophy, are not
preventable. Conditions that are preventable and/or
treatable include:
Slowing the Decline In Fertility Issues
To maintain maximum fertility, men should:
- Maintain optimal
weight
- Avoid recreational drugs and smoking
- Maintain general wellness – don’t leave
health conditions such as high cholesterol untreated.
High
cholesterol has been shown to be associated with
erectile dysfunction.
- Adopt an annual physical and screening program
– many men with testicular cancer are unaware
of this condition.
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Skin WIth Aging
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