Condition & Treatments
/ Fertility after 40
Becoming a father after 40: what changes, and what you can do about it
Men don't have a sudden "menopause", but the male biological clock is real. From around 40, sperm quality gradually declines and sperm DNA damage increases. The good news is that much of this can be measured, and some of it improved.
I N S H O R T
With age, semen volume, sperm movement and shape decline, and sperm DNA damage increases [1, 2].
Older fathers face a longer time to pregnancy and a higher risk of miscarriage, even when the partner is younger [2, 3].
A specialist assessment can find treatable problems, such as a varicocele or hormone imbalance, and improve sperm before you try naturally or with IVF.
What the research shows
A review of 90 studies including almost 94,000 men found that semen volume, motility, normal morphology and DNA integrity all decline with age [1]. Over 40, sperm DNA fragmentation rises by around 3% a year, and the risk of miscarriage roughly doubles [2]. There is also a small increase in some genetic and developmental conditions in children of older fathers, although the overall risk for any one child remains low [2, 3].
What can help
Treating the cause: varicocele repair, treating infection, or correcting hormones.
Reducing DNA damage: lifestyle changes, targeted antioxidants and shorter abstinence.
Sperm freezing now, if you plan to have children later, so younger sperm is available.
Choosing the right route: natural conception, IUI or ICSI, depending on your results and your partner's age
Testicular sperm for ICSI, if DNA damage stays high, taken fresh on the day of egg collection.
Why this matters to your care
Fertility clinics usually focus on the woman's age. Prof Raheem looks at the male side too, so you know where you stand and what can be improved before time becomes a bigger factor.
Is it too late to become a father?
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Usually not. Many men become fathers in their 40s and beyond. The aim is to give you the best chance, as early as possible.
Should I freeze sperm?
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If you plan to have children later, freezing sperm now keeps younger sperm in reserve.
Does my partner's age matter more?
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Both matter. Your age adds to hers, especially for time to pregnancy and miscarriage.
References
1. Johnson SL, Dunleavy J, Gemmell NJ, Nakagawa S. Consistent age-dependent declines in human semen quality: a systematic review and meta-analysis. Ageing Research Reviews, 2015. Link
2. Reproductive genetics and the aging male. Journal of Assisted Reproduction and Genetics, 2018. Link
3. Advanced paternal age: effects on sperm parameters, assisted reproduction outcomes and offspring health. Link