Age Related Infertility (ARI) Part 2

Kemi Ailoje

The Facts: Men, Age and Fertility

Last week, we talked about age related infertility in female, today we shall be addressing issues relating to men’s age as it causes decline in fertility.

The quality of a man’s sperm decreases with age. As a man ages, it takes longer for his partner to get pregnant. There is also an increased risk of not conceiving at all. Whatever the age of the mother, the risk of miscarriage is higher if the father is over 45. The children of older fathers are at greater risk of autism, mental health problems and learning difficulties.

• The average time to pregnancy if a man is under 25 years is just over four and a half months, but nearly two years if a man is over 40 (if the woman is under 25 years).

• There is a five-fold increase in time to pregnancy if the male partner is aged over 45 years.

• For couple having IVF, the risk of not having a baby is more than five times higher if the male partner is aged 45 years or older.

• The volume of a man’s semen and sperm motility (the ability of a sperm to move toward an egg) decrease continually between the age of 20 and 80.

• The risk of miscarriage is twice as high for women whose male partner is aged over 45 than for those whose partners are under 25 years.

• Children with fathers aged 40 years or older are more than fives as likely to have an autism spectrum disorder than children fathered by men aged under 30 years

As men age they are more predisposed to conditions that may reduce their fertility such as:
• Benign Prostate Hyperplasia
• Loss of libido (sexual drive)
• Erectile dysfunction.
• Poor sperm quality and motility (asthenozoospeemia)
• Poor sperm quantity (Oligospermia); or No sperm (Azospermia)
• High percentage of abnormal sperm (Teratozospermia)
• Medical conditions such as Obesity, Diabetes, Hypertension.

These and many more factors which become more pronounced and severe as age sets in men,impacts negatively on the male fertility.

Is it possible to overcome the barrier of Age Related Infertility in Males and Females?
Yes of course, despite what may seem like somber odds, there are still measures we could apply to beat infertility due to aging, through some of the under listed processes:

Fertility preservation of oocytes (eggs) and sperm
Fertility preservation is the process of saving or protecting eggs or sperm or reproductive tissue so that a person can use them to have biological children in the future. People with certain disease and disorder, and life event that affect fertility may benefit from fertility preservation.

These include people who may:
• Delay having children
• Have uterine fibroids
• Are about to be treated for cancer
• Are about to be treated for an autoimmune diseases
• Have genetic disease that affect future fertility
• Have been exposed to toxic chemical in work place or during military duty

Fertility preservation such as ovarian tissue or oocytes cryopreservation (egg freezing) may also prevent infertility as well as birth defects associated with advanced maternal age. In this case, the woman after receiving doses of hormonal medication to stimulate oocytes (eggs) development in the ovaries will have eggs extracted and cultured in the laboratory and also frozen in liquid nitrogen gas, this process is called Oocytes Cryopreservation. These eggs may however befertilised with own or donor sperm and cultured in the laboratory to form an embryo which is frozen by days 3 or 5 and this process is called Embryo Cryopreservation.

Ovarian tissue can also be cryopreserved but it is re-implanted into the body to allow the encapsulated immature follicles to complete their maturation.

Sperm Cryopreservation: commonly referred to as sperm banking. It is a procedure to preserve sperm cells. Semen can be used successfully indefinitely after cryopreservation. For human sperm, the longest reported successful storage is 24 years. It may be beneficial to men undergoing vasectomy or treatments that may compromise their fertility, such as chemotherapy, radiation therapy or surgery.

Donor Eggs IVF: A younger woman who has been appropriately screened and matched to the older woman, is treated through the process of IVF, eggs collected is fertilised with the patient’s husband’s sperm and embryos transferred to the woman’s uterus (womb).

Embryo donation: This is the option of treatment to couple with male and female factor infertility. An embryo obtained from the process of IVF by some couple is given away to other couples who need them without compensation. Most often the embryos are donated after the woman from whom they were originally created has successfully carried pregnancy to term.

Pre-implantation Genetic Screening (PGS): This is a procedure done prior to implantation to help identify genetic defects within embryos. This serves to prevent certain genetic diseases or disorders from being passed on to the child. From embryos gotten through the process of IVF, a cell is removed to test for overall chromosomal normalcy. Embryos whose cells test abnormal will not be transferred back to the womb to prevent having abnormal babies as well as pregnancy that may end up in miscarriage, ensuring delivery of healthy baby.