Women often get much of the blame when they are unable to become pregnant. But the reality is, male fertility is a contributory factor in 30 to 40 percent of infertility cases and may require treatment as well. What are the causes of male fertility decline? How is it different or similar to female fertility? Women are born with a limited, non-renewable number of eggs. Whereas, men produce over 100 to 200 million new sperm per day. Therefore, it’s safe to say that men have zero chance of running out of sperm as they increase in age, unlike women. However, there are several factors that can impact sperm production or its release, causing decline in male fertility. In this article, we will discuss the studies on male fertility decline, reasons behind it, their relation to infertility, and the treatment options offered at our fertility clinic (Orange County).

What are the causes of male fertility decline?

There are several factors that may cause fertility decline in males, such as age, lifestyle choices, medical issues/injuries, and environmental/medical history factors. Now, let’s talk about them one after the other.

Medical issues

Male fertility decline can result from several medical issues that may lead to infertility. For example, it may affect sperm production/function or interfere with the release of sperm out of the body (ejaculation). Some of them include:

• Illnesses, including infections like orchitis (inflammation of the testicles), epididymitis (inflammation of the epididymis), or certain STI (sexually transmitted infections); hormone imbalances; injuries to the testicles or other parts of the male reproductive system; tumors/cancers that impact the glands associated with reproduction (like pituitary gland).
• Anatomical issues like varicocele can affect sperm production. It is the swelling of the veins within the loose bag of skin that holds the testicles. Male fertility decline can also be caused by issues related to the abnormal release of sperm. Such cases may require fertility treatment procedure. For example, congenital absence of vas deferens, a medical condition that prevents the sperm produced in the testicle from being released into the ejaculate.
• Chromosomal defects that results in abnormal development of the male reproductive organs.
• Issues with ejaculation or sexual intercourse, like erectile dysfunction, painful intercourse, premature ejaculation, or retrograde ejaculation. (Note: in retrograde ejaculation, the semen drains into the bladder instead of coming out of the penis tip during ejaculation).
• DNA fragmentation – this means that the sperm DNA is abnormal, raising the odds of failed pregnancy or miscarriage.

Environmental or medical treatment history that can affect male fertility

The following may also cause Male fertility decline:

• Medications, like ulcer drugs, cancer medications, testosterone replacement therapy, antifungal drugs. These and some other medications may affect sperm production and result in male fertility decline.
• Surgeries that obstruct the path through which sperm passes, for example, prostate surgeries, vasectomies, hernia repairs, or testicular surgeries.
• Environmental factors, like overexposure to heavy metals, radiation, or industrial chemicals.

Lifestyle

As with female fertility decline, there are several behaviors that can affect the rate of male fertility decline, like:

• Illegal drug use, like the use of marijuana, cocaine, or anabolic steroids
• Alcohol use, which can lead to erectile dysfunction, reduce testosterone levels, and lower sperm production.
• Smoking, which can cause a lower sperm count and development of infertility symptoms.
• Obesity, which can affect sperm itself or result in hormone changes that cause a decline in male fertility.

Male fertility decline with age and fertility treatment options

Both men and women experience fertility decline as they age. However, age-related fertility decline is less dramatic and less significant in males than in females. Nonetheless, fertility experts of our Orange County fertility clinic advise both males and females to opt for fertility treatments such as ICSI, IVF, and IUI if they are struggling with infertility due to their age.

What leads to age-related male fertility decline?

• Decreased sperm motility. The term “motility” refers to the ability of sperm to travel toward the female egg. Research shows that sperm motility reduces with age. A study of healthy male non-smokers indicated that sperm motility reduced by 0.8 percent every year. Sperm motility is developed as the sperm passes through the prostate and epididymis. Thus, a decrease in motility is believed to be a result of age-related reduction in the function of these glands.
• Decreased sperm morphology. Sperm morphology refers to the shape and size of sperm. According to various studies, normal sperm morphology reduces by 0.2 to 9 percent every year. This accumulates to a 4 to 18 percent decline in morphology over a period of 20 years. Thus, a lower number of normally shaped sperm may result in male infertility. Abnormally shaped sperm is less likely to successfully fertilize an egg.
• Decreased seminal volume. Seminal volume – which refers to how much semen is released per ejaculation – may slightly decrease with age. According to some reports, seminal volume usually decreases by 0.15 to 0.20 percent every year. This adds up to a 3 to 4 percent decrease over a period of 20 years. The most significant changes occur in men aged 45 and above. However, some studies conclude that there’s no significant difference in seminal volume with age. This is why its effects on male fertility decline are unclear.

Other effects of male age

Age might not be the most significant factor regarding male fertility decline and can be overcome with the right treatment process. However, it has some other huge impacts on the health of the pregnancy and the baby. There is evidence that the risk of miscarriage increases with the father’s age, perhaps due to genetic disorders in the sperm.

Moreover, the baby’s chances of autism, schizophrenia, and birth defects – all increase with paternal age. In a report, children of men above 50 years of age were 2.2X more likely to suffer from autism compared to the children of men below the age of 29. Similarly, another study found that the risk of schizophrenia increased with the age of the father. Moreover, men above 40 were 2X more likely to beget children with schizophrenia.

However, researchers are yet to fully understand the mechanism for this affect. These increased rates of illness may be caused by what fertility experts refer to as “de novo mutation“. It is a genetic alteration that is appearing for the first time. On the other hand, according to a 2016 study, de novo mutations may just be a tiny part of the cause. Researchers believed that men with a genetic tendency for mental illnesses might also be more likely to postpone fatherhood.

Why it is important to understand male fertility decline

Just like their female counterparts, men are also waiting longer to become parents. In the United States, the average age of a newborn’s father has increased to 30.9, going up from 27.4 in 1972. However, this trend is not peculiar to the US alone but can be seen all around the world. In Germany, the average age of a newborn’s father has increased to 33.1. Whereas, in England, fathers above 35 accounted for 40 percent of all children born in 2003 (compared with 25 percent in 1993). Because age is an important factor in male fertility decline, it is good to know the possible impact of delaying parenthood on the ability of older couples to conceive and have healthy children.

Fertility treatment and preserving male fertility

The same way egg freezing can preserve women’s fertility, sperm freezing is a good option for men worried about male fertility decline & infertility issues. These may include men who are more likely to have injuries, such as those in the army or those who are about to undergo medical treatment like chemotherapy – which may also impact fertility. Fertility specialists at our Orange County fertility clinic recommend that men who are not likely to have children until their forties or fifties consider sperm freezing when they are in their thirties.

Conclusion

Do you want to know how we can help with male factor infertility at our Coastal Fertility Medical Center and what fertility treatment options are there? Contact us at (949)-726-0600 to schedule a consultation or you can explore our website to learn more about male fertility.