This is what published in newspaper recently.
A recent paper published in Maturitas journal, Elsevier, looked at all published data on effect of advanced paternal age (APA) on fertility, pregnancy and health of the child and suggested that ‘men should be encouraged to bank sperm before their 35th or, at least, their 45th birthday’.
What is this article about?
This is a narrative review of existing literature, where the authors showed that there are increased genetic abnormalities with aging sperm, which can lead to less success from IVF, miscarriages and birth defects.
Low testosterone in older men can lead to decrease in sperm quality and can take longer time to get pregnancy. Studies looking at over 700,000 births showed increased risk of pre-eclampsia and gestational diabetes during pregnancy in women with older partner.
Children born to older fathers are found to have lower birth weight, premature births and increased risk of stillbirth. Not only that, studies have also shown increased risk of autism, psychotic disorders and schizophrenia in children born from older fathers. In addition, some studies have shown association of childhood cancers like leukaemia, non-Hodgkin’s lymphoma in children born to older fathers.
However, what is not clear is at what age of men these effects manifest.
In the current paper, the authors have suggested that ‘APA (advanced paternal age) can be defined as anywhere from over 35 to over 45 years of age’. They go on and also suggested, ‘men should be encouraged to bank sperm before their 35th or, at least, their 45th birthday to decrease the increased risks on maternal, foetal and child health which have been shown to occur as a result of ageing sperm’.
What is sperm freezing and when it is currently considered?
Freezing sperm is widely used for men undergoing cancer treatment or men in armed forces or those undergoing gender transition to female. Men undergoing IVF treatment sometimes need to freeze their sperm if their count is very low or they are unavailable due to work purpose.
What does sperm freezing involve?
Before freezing sperm, men would be asked to do virology screen (HIV, Hepatitis B and C) to ensure that affected sperm are stored appropriately without contaminating other samples. Once the semen sample is provided it is then checked for count, motility and normal forms and then stored in containers called straws.
Is sperm freezing safe?
This is quite safe procedure as IVF with frozen sperm is as successful as IVF with fresh sperm. However, not all sperm will survive the defrosting process. There is no risk to children in using frozen sperm for the treatment.
How long can the sperm be stored?
The standard period of freezing in the UK is 10 years. That means if it is not used in 10 years, it will be discarded. This is different for some cancer patients, when it can be stored longer, up to 55 years.
What is the cost of freezing sperm?
The cost of sperm freezing differs between different clinics, varying between £200 – 425. In addition to this there will be annual storage fee.
So, should men freeze their sperm before 35th or, 45th birthday (as suggested in this paper), if they wish to delay their pregnancy?
In my opinion, the solution is not in freezing sperm.
There is no doubt that age will impair the quality of sperm. However, by far, most men over the age of 35 years will still be fertile.
Freezing sperm before the age of 35 years, will mean, in future these men will need to undergo fertility treatment to use those sperms.
Most elderly men will achieve pregnancy naturally if their female partner is young. So majority will not need to undergo fertility treatment to conceive. So even if they freeze sperm, they might not use it.
Using frozen sperm and artificial reproductive techniques in an otherwise fertile couple, makes the whole process of procreation very artificial.
What is needed is social awareness.
We need more input in raising fertility awareness and supporting young couples to balance career and relationship so that they complete their family at a younger age before the natural decline in fertility and be more aware of the implications of delaying pregnancy.
Awareness is also needed among the medical professionals so that they include the discussion about the effect of advanced paternal age on fertility just as they do about the effect of advanced female age.
Written by
Dr Anupa Nandi
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