Male biological clock A critical analysis of advanced paternal age

Capsule:
Despite relatively rare, although potentially serious, risks to offspring, advanced paternal age should not be a contraindication for conception.

Authors:
Ranjith Ramasamy, M.D., Koji Chiba, M.D., Ph.D., Peter Butler, B.A., Dolores J. Lamb, Ph.D.

Volume 103, Issue 6, Pages 1402-1406

Abstract:

Extensive research defines the impact of advanced maternal age on couples’ fecundity and reproductive outcomes, but significantly less research has been focused on understanding the impact of advanced paternal age. Yet it is increasingly common for couples at advanced ages to conceive children. Limited research suggests that the importance of paternal age is significantly less than that of maternal age, but advanced age of the father is implicated in a variety of conditions affecting the offspring. This review examines three aspects of advanced paternal age: the potential problems with conception and pregnancy that couples with advanced paternal age may encounter, the concept of discussing a limit to paternal age in a clinical setting, and the risks of diseases associated with advanced paternal age. As paternal age increases, it presents no absolute barrier to conception, but it does present greater risks and complications. The current body of knowledge does not justify dissuading older men from trying to initiate a pregnancy, but the medical community must do a better job of communicating to couples the current understanding of the risks of conception with advanced paternal age.

  • Dr. Ramasamy and colleagues present a very succinct discussion on the risks of fathering offspring with advanced paternal age. They attempt to define what is advanced paternal age based on the available data in the literature, which is a very difficult task since no real cut points are available and risk is on a what appears to be a linear continuum.

    It would appear, based on their table 1, that men >40 should be counseled extensively of the increased risk of malignancy, genetic defects, and abnormal syndromes in their offspring. They do not address the neuropsychiatric disorders as this is presented in another article in this month’s journal.

    Take home message: Men also have a biologic clock and it is ticking just like those of their female counterparts. We cannot just lay blame upon the fairer sex because they are older because, as this article and others in this month’s journal demonstrate, we can also be the cause of abnormalities.

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