Male Age and Fertility

We focus a lot on female age and fertility in our fertility practice and in the media. But, there are also known effects of male age on fertility and the health of their children. In this episode, Louis Weckstein, MD, addresses all of the varying factors that can impact men's fertility.
Male Age and Fertility
Featuring:
Louis Weckstein, MD
Dr. Louis Weckstein received his training in infertility at University of California-Irvine in 1988 with one of the most successful IVF teams in the country at that time. After establishing a successful OB/GYN private practice in Southern California, he returned to training that included special emphasis on assisted reproductive technologies. He is certified by the American Board of Obstetrics and Gynecology and is a member of the Society for Assisted Reproductive Technology and the Society for Reproductive Surgeons.

Dr. Weckstein has served on the board of directors of the Pacific Coast Reproductive Society and was a past California representative to the National Advisory Council of the American Society of Reproductive Medicine. Dr. Weckstein has authored more than 50 publications and abstracts with a focus on IVF and Egg Donation. He serves as a special reviewer for the infertility journal “Fertility and Sterility.” He is medical and IVF director at RSC. Dr. Weckstein also serves on Progyny’s Medical Advisory Board.

•Reproductive Science Center of the San Francisco Bay Area

•Undergraduate degree: University of Michigan

•Medical training: University of Michigan

•OB/GYN residency: University of California, Irvine

•Postgraduate training in IVF and infertility: University of California, Irvine

•Joined RSC Bay Area: 1990

•RSC location: San Ramon facility
Transcription:

Bill Klaproth: Does a man's age affect fertility and health of his children? You know, we focus a lot on female age and fertility, but there are also known effects of male age on fertility and the health of their children. So how does a man's age affect his sperm count? Let's find out what Dr. Louis Weckstein IVF and Medical director at Reproductive Science Center of San Francisco Bay. This is Fertile Edge, a podcast by Reproductive Science Center of San Francisco Bay. I'm Bill Klaproth, Dr. Weckstein. Thank you for your time. Let's start with this. So how does a man's age affect his sperm count?

Dr. Louis Weckstein: Interestingly, Bill, sperm count is often not affected by male age, but there are effects of older age on semen volume, which is the amount of the liquid, sperm motility or movement, and sperm DNA fragmentation or the breaks in the genetic material. And these factors can affect the chance for pregnancy as well as the health of the pregnancy.

Host: All right, so let's stick with the DNA and breaks in genetic material. How does a man's age then affect the genetics of his embryos and offspring?

Dr. Weckstein: Increasing female age. We've known for a long time significantly affects the percentage of embryos that are chromosomally abnormal in an IVF or in vitro fertilization setting. Some studies have also suggested that embryos from older men have a higher percentage of genetic abnormalities, but a recent large study testing almost 7,000 embryos found no association between older male age and the overall rate of embryo chromosomal abnormalities. There does appear to be a slight increased risk of down syndrome or trisomy 21 with older paternal age, but this is much less significant than that associated with older maternal age and there seems to be an increased rate of miscarriages in pregnancies fathered by older men. Even when you adjust that for older maternal age. Pregnancies from older paternal age also seem to have an increased risk for very premature birth interestingly.

Host: And I've also heard that older men's children have a higher chance of having autism. Is that true?

Dr. Weckstein: Yes, there is now a significant amount of evidence that advanced paternal age significantly affects the risk of having a child with autism spectrum disorder, ADHD, or attention deficit hyperactivity disorder, and other psychiatric disorders including bipolar disease and schizophrenia.

Host: And do we know the percentage of that at all?

Dr. Weckstein: It is relatively speaking a very low percentage, but it is definitely statistically significant.

Host: And then what other problems can occur in children of older men?

Dr. Weckstein: There's a slight increased risk for birth defects in general, specifically cleft palate, neural tube or spinal defects, and congenital heart defects with advancing male age.

Host: So are there any ideas as to why older men's offspring may be at a higher risk for these problems?

Dr. Weckstein: Yes, we think possible reasons might be the long-term accumulation of environmental exposure to toxins that could affect DNA, genetic material fragmentation in sperm. And we also think these toxins could affect female fertility as well. And in older men, just the overall increased frequency of genetic mutations that we know can arise in the older sperm.

Host: So I feel like we've kind of been all doom and gloom here, but it is important to understand the risks. But just to reassure anyone listening right now, is it fair to say the vast majority of children born to older men will be healthy? Is it fair to say that?

Dr. Weckstein: Yes. In most situations. The vast majority of children born to older men will be healthy.

Host: So that is the good news. Most babies born to older men will be healthy, but it is important to understand the risks. So as we talk about older men having children, is there anything men in general can do to reduce the chance for these problems in their children?

Dr. Weckstein: Yes. Some of these effects on sperm could possibly be diminished by reducing what's known as oxidative stress in your body through eating a balanced, healthful diet, rich in fruits and vegetables, limiting intake of processed foods, particularly those high in sugars and fats. Definitely exercising regularly and very importantly, stopping cigarettes smoking. We also think that taking antioxidant multivitamins may also be helpful. Some doctors have recommended doing in vitro fertilization with preimplantation genetic testing for infertility couples with an older male partner. And this is certainly reasonable, but it doesn't screen for all the disorders we've spoken about today. So IVF with PGT would only detect chromosome abnormalities like down syndrome and it could also reduce miscarriages. But overall, I want to reassure our listeners that the vast majority of children born to older men will be healthy. However, both the infertility patients using fertility treatment and couples trying to conceive on their own should be aware of the effects of male age on fertility and children's health.

Host: So it just makes sense then to do IVF with PGT if it is an older male saving their sperm?

Dr. Weckstein: It certainly a very reasonable thing to do. Yes.

Host: So for someone listening, we keep mentioning older men, I think we should maybe try to clarify that a little bit. When we speak of older men, is that over 30 over 40, 45, 50? Can we narrow that down a little bit?

Dr. Weckstein: Yeah. When you think about things genetically and over time, people in general reproduced or had children at a much younger age. So even, you know, a hundred years ago, 40 would be considered quite old. These days, I think certainly more of these risks increase as you get close to 50, but there are slight increases even younger than a male age of 50. Whereas for a female age, you know, 40 is even quite advanced.

Host: Got it. Well that makes sense and that kind of helps narrow it down. Is there anything else we should know about this Dr. Weckstein, if you could wrap this up for us, what else should we know about this?

Dr. Weckstein: Sure. I would say that for both men and women trying to conceive in general, eating healthy, exercising, limiting cigarette smoking, all these things can be helpful and we can help with fertility treatment to help you to have the healthiest pregnancy possible.

Host: And that is what everybody wants. Dr. Wechstein, thank you for your time and if you're interested, Dr. Weckstein and I did a podcast called Why You Should Do Genetic Carrier Screening. Where we talk about that and PGT. I urge you to find that in our podcast library and listen to it. Dr. Weckstein, thank you so much for your time. We really appreciate it.

Dr. Weckstein: Thank you very much, Bill.

Host: That's Dr. Louis Weckstein, IVF and Medical Director at Reproductive Science Center of San Francisco Bay. And if you want to get connected with Dr. Weckstein or another physician, please visit RSCBayarea.com, that's RSCBayarea.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is The Fertile Edge by Reproductive Science Center of San Francisco Bay. I'm Bill Klaproth. Thanks for listening.