Published online by Cambridge University Press: 24 May 2020
This chapter considers the effect of paternal age on semen analysis, sperm function and DNA damage, as well as age-related impact on male fertility, both natural conception (time to conception (TTC)) and assisted reproduction technology (ART) outcomes, including intrauterine insemination (IUI), in vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI). The effects of advanced paternal age (APA) on health of offspring, including congenital birth defects, paternal age effect (PAE) disorders, and psychiatric spectrum disorders (schizophrenia, autism and dyslexia) are also discussed. Increasing male age results in a steady decline in semen quality, reduced sperm function, including acrosome reaction, proteomic and genomic expression and increase in sperm nuclear DNA damage. However, lack of a clear definition of advanced paternal age, and a variable impact on relevant endpoints (conception, miscarriage, live birth, child health) make discussions challenging for healthcare professionals when counselling patients regarding specific male age-related risks.
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