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.

NEXT: Male Skin WIth Aging

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