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What should we know about male infertility

Like the infertility issues in females, 
male fertility correlates with the age, lifestyle, and individual background. 
If you are aware of these factors, 
you may know more about your own body state.

With the dramatic change in recent society, people tend to start family late. We usually choose to pursue career first, and put starting our own family at the second priority. This decision made more people encounter the infertility problems at their late 30s and 40s of age. More and more studies demonstrated that the quality of oocyte declines with increasing female age. Thus oocyte cryopreservation for the social reason becomes more popular. How about the men? Several studies also found that the mean age of fathering men showed increased since 1993 to date. Meanwhile, the percentage of male factor in the entire population with fertility problem is increasing as well. The following 4 questions are frequently asked by our male cases,

1. Should semen analysis be routinely clinical testing?

Reproductive potential gradually declines with advanced paternal age, but the declining speed is not as fast as maternal ovaries. The semen analysis is the most common method to check the general sperm quality. Some studies indicated that there is significant decrease in semen volume, sperm concentration, sperm motility and sperm morphology among older men. The pregnancy rate in the men at 40s displayed 10% down than that in the men at 30s. Thus the males with advanced age and abnormal semen parameters have higher risk for the infertility issue. Should the semen analysis be routine testing? Maybe NOT. Only the couple who has failed to conceive for ≧1 year is recommended.

2. Should PGS (preimplantation genetic screening) be performed in the men at advanced age? 

The rate of aneuploid embryo is higher in women at advanced age (≧36 years old), and thus PGS becomes an option for them to choose the embryo with normal chromosomal dosage. Is it possible that the aneuploid embryo derived from the sperm with advanced paternal age ? Hassold et al. demonstrated that one of the cause for trisomy 21 is paternal chromosome nondisjunction, and it accounted for 20% of the entire population with trisomy 21. A more-recently scientific article showed that significantly increasing aneuploid rate in embryos from the older men and men with oligozoospermia. It appears that suboptimal sperm can be a source of embryo aneuploidy. However, the correlation of paternal age and embryo aneuploidy is not as strong as that of maternal age. For those with partner at advanced maternal age, or with the recurrent miscarriage history or family inherited disease, PGS/PGD is recommended. Generally, the paternal age is not the sole indication for PGS.

3. What should the older father know?

Several reports showed the children with older fathers are more likely to develop certain pathologies, such as the schizophrenia. The rate of autism spectrum disorders slightly increases as well. For the father themselves, some medical comorbidities do affect the fertility, like heart disease and chronic medicines of hypertension. It could lead to erectile dysfunction and benign prostatic hypertrophy.

4. Should males cryopreserve their sperm for social reason?

The sperm motility could be halved after cryopreservation. For men with known fertile issue, cryopresevation may induce sperm DNA damage. Since the correlation between fertility and male age is not as strong as the female age, there is no need to cryopreserve sperm for the social reason, and the state of frozen sperm is not comparable to the fresh sperm.

Beyond examinations, healthy diet and lifestyle do help the fertility. It's not necessary to cryopreserve sperm at young age. If the body stays good, the quality of sperm may remain for a long time.

Stork Fertility Center送子鳥 Stork Fertility Center送子鳥 Author

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