Is it possible for men to have 'lifetime' fertility?

Article by Dr. Tuong Thi Van Thuy - Team Leader of Biological Sample Source - Biobank, Vinmec Times City International Hospital.

According to a report in the popular journal Human Reproductive, USA, the average age to become a biological father for men globally has increased to about 3.5 years (1). The main statistical reasons were the trend towards late marriage, increasing life expectancy, career pursuits, high educational attainment, improved/convenient contraceptive methods, assisted reproductive techniques. Increasing fertility,...
However, scientific evidence and clinical practice are proving that male fertility also "aging" with age. Consists of:

Testicular volume declines gradually after age 60, which has been demonstrated by a decrease in the number of sperm-producing spermatocytes, impaired function of male hormone-secreting cells, and decreased cells perform a protective function.

Analysis of semen parameters of healthy men between the ages of 16.5 and 72.3 years old, author Stone B.A and colleagues have shown that the age milestones significantly decreased semen indexes. Specifically: total semen volume and total rapid motile sperm count after 34 years of age; Sperm concentration and sperm morphology were normal after 40 years of age, rapid sperm motility progressed to after 43 years of age, semen volume was after 45 years of age. Thus, the author proposes that the natural age for men to have children should be before 34 years old (2).

Numerous studies have shown a decline in the male hormone testosterone levels with age, including both total and free testosterone levels. This decline varies by study, ranging from 0.4% to 1.3%/year.

Sperm "integrity" is understood as the integrity of the genetic material of the sperm. This issue is of particular concern among men in general and especially in older men. This was set forth when clinicians and researchers observed that men with semen parameters within normal limits but still infertile. The cause has been found to be related to increased DNA fragmentation in older men. The mechanism is not yet elucidated, but defects in repair and regulation of cell division are thought to be the main mechanism responsible for DNA fragmentation as men age.
Besides, the risk of cumulative damage from infection, use of alcohol, tobacco and other toxins also increases with age. Antioxidant capacity decreases with age leading to oxidative stress that damages DNA and increases apoptosis in testes [8]. In addition to DNA integrity, errors in sperm viability were also evaluated in older men. Many studies have reported that the older a man is, the higher the percentage of aneuploid sperm and embryos in men. Some common abnormalities found in the sperm of older men include abnormalities on chromosomes 21, 22 and sex chromosomes X/Y

Results of male infertility treatment published in many studies show that the age of men is inversely related to the rates of infertility treatment. The cause was determined to be increased fragmentation of sperm DNA, increased risk of miscarriage. In patients undergoing IUI (intrauterine insemination), conception rates have also been shown to depend on male age.
In the technique of intracytoplasmic sperm injection (ISCI), reported data show that the fertilization rate decreases by 0.3% when the father's age increases by 1 year. In addition, some studies have demonstrated that advanced age is negatively correlated with pregnancy rate, implantation rate, and live birth rate, but positively correlated with miscarriage rate.

Another issue of top concern is the health of children born to an elderly father. Older paternal age is associated with low birth weight, or premature birth. A 2015 study found a 26% increased risk of musculoskeletal birth defects in children whose fathers were over 50 years old compared with those whose fathers were 25-34 years old.
Another study in the US has also reported an increase in respiratory, neuromotor, and genital malformations in children whose fathers are over 35 years old. A meta-analysis of 13 studies found a 58% increased risk of cleft lip and palate in the children of fathers over 40 years of age compared with fathers aged 20–39.
Aging not only affects sex, but also male fertility. Accordingly, the older the age, the lower the quality of the sperm, which can affect the fertility of men, the ability to conceive naturally, the ability to conceive for assisted reproduction as well as the health of the newborn baby. out. Although there are still opinions about the optimal methods, the recommendation that is made to preserve fertility in men who want to delay marriage and have children is to cryopreservate sperm at a young age.
Grasping the general trend of modern medicine, Vinmec Tissue Bank deploys both "private" and "public" sperm bank models in parallel to meet the demand for sperm storage on demand. demand (as a form of male fertility insurance) and donor sperm storage (to provide a source of high-quality sperm).
For details, please contact:
Tissue Bank - Vinmec International General Hospital 458 Minh Khai, Hai Ba Trung, Hanoi Hotline: 0899.550.189

References
Y.S. Khandwala, C.A. Zhang, Y. Lu, M.L. Eisenberg, The age of fathers in the USA is rising: an analysis of 168 867 480 births from 1972 to 2015., Hum. Reprod. 32 (2017) 2110–2116. Stone B.A., Alex A., Werlin L.B., Marrs R.P. Age thresholds for changes in semen parameters in men. FertilSteril. 2013;100:952–958. D. Durairajanayagam, Lifestyle causes of male infertility, Arab J. Urol. 16 (2018) 10–20. S. Gunes, G.N.T. Hekim, M.A. Arslan, R. Asci, Effects of aging on the male reproductive system., J. Assist. Reprod. Genet. 33 (2016) 441–454. S.K. Urhoj, P.K. Andersen, L.H. Mortensen, G. Davey Smith, A.-M. Nybo Andersen, Advanced paternal age and stillbirth rate: a quality register-based cohort study of 944.031 in Denmark, Eur. J. Epidemiol. 32 (2017) 227–234.