Understanding Male Fertility: Key Factors And Age-related Decline

Unlike women, who are born with a limited number of eggs, men produce new sperm every day. The testicles produce around 100-200 million new sperm every day, so men are not at risk of running out of sperm as they age. The decline in male fertility can be caused by various factors, including medical conditions, environmental factors, lifestyle and age.

Dr Archana Dhawan Bajaj, Gynecologist, Obstetrician and IVF Expert, at Nurture IVF Clinic, New Delhi said that various medical conditions can affect sperm production or the ejaculation process. These include infections such as epididymitis, anatomical problems such as varicocele (swelling of the veins that drain the testicles and can affect sperm production) and problems with sperm delivery. Chromosomal abnormalities that result in abnormal development of the male reproductive organs, problems with intercourse or ejaculation such as erectile dysfunction, premature ejaculation or painful intercourse, and DNA fragmentation (in which the DNA in the sperm is abnormal, increasing the risk of failed conception or miscarriage) are also important medical causes.

Environmental and medical history factors can also contribute to the decline in fertility. Certain medications, including testosterone replacement therapy, cancer treatments such as chemotherapy and radiation, some antifungal drugs and medications for ulcers can affect sperm production. Previous surgeries such as hernia repairs, scrotal or testicular surgery, prostate surgery or vasectomies can block the path of sperm. Excessive exposure to industrial chemicals, heavy metals or radiation can also affect fertility.

Lifestyle choices play a crucial role in male fertility. The use of illegal drugs such as anabolic steroids, cocaine or marijuana, and habits such as drinking alcohol and smoking contribute to lower sperm counts. Obesity can have a direct impact on sperm and cause hormonal changes that affect fertility.

The decline in male fertility with age is not as dramatic as in women, but it is still significant. Studies show that the chances of not becoming a father increase as a man gets older and pregnancy rates decrease. For example, men over 40 are 30 per cent less likely to achieve fatherhood within a year than men under 30. Men over 45 take an average of five times longer to achieve parenthood than men under 25. For men over 35, the rate is 25 per cent, compared to 52 per cent for men under 35.