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Showing posts with label fertility. Show all posts
Showing posts with label fertility. Show all posts

Thursday, October 3, 2013

How your age can affect your fertility

Can a man's age affect his fertility?
Yes, it can. Men have a biological clock of sorts. Men in their 70s or even 80s can, and do, father children. But a man this age is more likely to take years rather than months to get his partner pregnant.

The older a man is, the longer it will take him to get his partner pregnant. The chance of conception taking more than a year is:

    about eight per cent when the man is under 25
    about 15 per cent when the man is over 35

An age gap can make a difference, too . If a woman's partner is at least five years older than her, she has less chance of conceiving within a year than if her partner is the same age. That's the case whatever the woman's age.

How do men and women's biological clocks differ?
There is a clear difference between men and women. A woman's oestrogen levels plummet once she reaches a certain age and this change is irreversible. The changes in hormone levels men experience aren't as sudden or noticeable, but happen gradually. The other major difference is that all women eventually reach menopause and stop releasing eggs. But a man can usually produce sperm throughout his lifetime.

Are genetic problems linked to older men?
Very rarely, problems are associated with the dad being older. The following conditions may be linked the age of the dad:

    Restricted growth (achondroplasia) or dwarfism. Achondroplasia is very rare. It affects about one in 10,000 births. So, as a couple, it's highly unlikely that your child would be affected by achondroplasia.
    Down's syndrome, a genetic condition that causes learning difficulties and some health problems.
    Schizophrenia, a long term mental health problem.

Not all experts agree about the link between the dad's age and these conditions, though. It's possible that factors other than the dad's age can have an effect.

For example, whether or not somebody develops schizophrenia can depend on several factors. These include a family history of the disease, as well as lifestyle and social factors, such as using drugs, being bullied and growing up in a city.

It's known that a mum's age is a risk factor for Down's syndrome but there is still debate about how relevant a dad's age is. Overall, it's been found that the risk of Down's syndrome is highest when both parents are over 35.
Why are genetic problems more common as we get older?
Both younger and older men develop damaged or unhealthy sperm, but usually a natural process called apoptosis gets rid of them. However, apoptosis does not occur as efficiently in older men. This means that a higher percentage of damaged sperm get into the semen of men over 35 than in those of younger men.

Women who are 35 and under have a built-in mechanism in their eggs that repairs damaged DNA introduced by the sperm. But that safety net starts to break down after the age of 35. That's why some of the risks of genetic disorders only matter when both the mum and dad are older.

The risk of miscarriage, so often caused by genetic abnormalities, is only increased for older dads when the mum is aged 35 or more too.

Does weight affect male fertility?
Yes, men who put on a lot of weight increase their risk of fertility problems. Being obese can reduce the quantity and quality of your sperm. It may also mean that you have health problems, such as heart disease and diabetes, which may affect your ability to get an erection.

An extra four or five points on a man's BMI (body mass index) can age his testosterone levels by 10 years. A waist size of 102 cm (40in) or more is also a risk factor for heart disease in men. Heart disease slows blood flow throughout all parts of the body, including the penis.

Diabetes is another weight-related medical condition common in older men. Diabetes can interfere with libido and reduce sperm quality.
What can older men do to boost their fertility?
So that's the bad news. Now for the good. There is plenty men can do keep their fertility and potency in tip-top condition. Eating healthily is a great start. Some fertility problems linked with obesity may be reversible. Losing weight may lead to improved sperm count.

Lifestyle changes could improve fertility too. Before trying to become a dad, it may be worth having a health check-up at your local surgery.

Causes of male infertility are almost always easier to identify and fix than female infertility. Most of the common problems are also more likely to be experienced by older men. These problems could include:

    a low sperm count
    ducts that carry ejaculating sperm becoming clogged
    infection in the testes
    problems getting an erection

If a couple is having problems getting pregnant, it's just as important for the man to see a specialist as it is for the woman.

Finally, you can comfort yourself with the fact that, while male fertility may gradually decline with the years, the majority of men will still be fertile and functioning at 60 and beyond. 

Friday, September 20, 2013

Erectile Dysfunction, Fertility, and Men’s Health

Recent studies have suggested that as men age, testosterone levels will often drop to very low levels. In fact, about 25-30% of men in their fifties may have low levels. If erectile dysfunction is the only concern, then after evaluation, hormone replacement can be very rewarding. But, if fertility is a concern, the addition of testosterone can further lower a sperm count which may already be lower than normal. I have started to measure testosterone levels in men who object or complain about providing a sperm sample and despite reports of not having problems with ED, many of these men have low testosterone levels.

What is so interesting is that we are learning that ED is strongly linked to cardiovascular disease. Men with ED demonstrate increased calcium in the blood vessels of the heart at a younger age. Insulin and nitric oxide are important in both conditions. Men with ED are more likely to have a decreased HDL [good cholesterol] /total cholesterol ratio, putting them at greater risk for heart disease. Some authors have suggested that men with ED are cardiac patients until proven otherwise, and that men with increase cardiac risk factors will soon demonstrate ED if they have not already done so.

Nitric Oxide (NO) is a potent blood vessel dilator and as such is the prime factor in allowing extra blood to pool in the penis resulting in an erection. It is also responsible for dilating the coronary blood vessels and increased blood flow to the heart when needed. NO produces other factors which prevent platelet stickiness and the formation of atherosclerosis plague formation on blood vessel walls. While the use of Viagra may restore function, it does not address the underlying cardiovascular risk that often goes along with ED.

Things that increase NO will likely improve erectile function and will be cardioprotective. Testosterone replacement is beneficial for men who are not trying to produce a pregnancy, but there are other factors to consider. Exercise, antioxidants, folic acid [25% of us need excess folic acid due to dietary deficiencies and genetic differences] omega 3 fatty acid supplementation, calcium and L-arginine. Things to avoid include a high-fat diet, trans fats, obesity, sugar, and alcohol.