Fertility History and Life Span

We used to assume that men could become fathers up until their 60s and beyond. When it came to declining fertility the focus was generally on women. However, the assumption that male fertility isn’t affected by age is no longer accurate. We now understand that men’s fertility declines and changes with age, just as women’s does. These changes can affect pregnancy as well as the health of the child.

The actual age at which men’s fertility begins to decline is less clear, but it appears that sperm count and quality begin to noticeably change for many men in their early 40s. Older male age has been linked with a higher likelihood of miscarriage, despite a woman’s age. The children of older fathers also have higher rates of learning disabilities, autism, schizophrenia and bi-polar disorder.

If you’re concerned that your fertility might be declining, and you want to have kids, you may decide you’d better start trying now, rather than risk the chance that your fertility might decline in a few years time. Or, if you’re not ready to have children yet, or you aren’t sure you even want to have kids but you definitely want to keep your options open, you may want to consider fertility preservation.

Women’s fertility begins to decline as early as their late 20s and early 30s. The decline is accelerated around age 35 and continues through the early 40s until menopause. For women trying to have children in their 30s or over, this means it will likely take longer to get pregnant. Some women may end up having fewer children than they had hoped to have. With advanced maternal age, there is an increased risk of miscarriage (50% for women 44 years of age), more complications during pregnancy (e.g. gestational diabetes; pre-eclampsia), more premature births, and higher rates of chromosomal abnormalities such as downs syndrome (1 in 30 for women 45 years of age) among babies born to older mothers who use their own eggs.

It may seem that many celebrities are having babies into their late 30s, 40s and 50s. What they usually don’t reveal is that many used the eggs of a younger woman to become pregnant. When an older woman uses a younger woman’s eggs, pregnancy rates are higher and the risk of chromosomal abnormalities for the baby are significantly reduced. However, there are still higher risks of miscarriage for these older mothers, and of pregnancy complications and premature births.

If you are over 35 and want to have a child, you should consult with your doctor about your fertility status and the implications of a pregnancy, given your age and family history. If you are unable to use your own eggs or are concerned about the risks to a child based on the age of your eggs, you may want to consider third party reproduction (donated egg / embryo).

In the majority of cases an abortion has no affect on later fertility. However, in rare cases the cleaning out of the uterus, also known as a D & C (dilation and curettage) may cause some scarring inside the uterus. Also, the dilation of the cervix during an abortion could weaken the cervix, although again this is very rare. Both of these conditions may make it more difficult to get pregnant and to carry a pregnancy to term.

On the positive side, having achieved a pregnancy in the past is a good indicator that you ovulate, and that your fallopian tubes are open.

If you have had an abortion in the past and you have been trying, unsuccessfully, to get pregnant for at least 6 months, you may want to ask your doctor for a referral to a fertility specialist. A procedure known as a hysteroscopy can be done to check the inside of your uterus, and in many cases, the problem can be repaired during the procedure.

Although some STIs can affect fertility, having had an STI doesn’t necessarily mean that you are infertile. If an STI is detected and treated early, the risk of permanent damage to fertility is reduced. However, if left untreated for too long, common STIs like Chlamydia can cause pelvic inflammatory disease (PID) – a condition that can result in permanent damage to the fallopian tubes and uterus. Fallopian tubes may become blocked preventing eggs from moving into the uterus. This infection can be “silent” so you may not realize you have PID until you try to become pregnant.

Men who have STIs more often experience noticeable symptoms and thus tend to get treatment before any permanent damage has been done to their fertility. Men who have had gonorrhea and Chlamydia and have not been treated may experience scarring and blockage in the sperm duct, a condition that can affect their fertility called epididymitis. Other STIs like genital herpes and syphilis can also negatively impact a man’s fertility.

Infertility as a result of STIs can usually be prevented if treated early. Get tested and seek treatment if you think that you might have an infection or have been exposed to someone who does.

If you think that your fertility may have been affected as a result of having had a STI, you may want to see a fertility specialist for a comprehensive assessment. A fertility specialist will be able to interpret the test results and discuss your options.