REPRODUCTIVE FUNCTIONS OF THE AGEING MALE Moshe Shalev MD Department of Urology Meir Medical Center Kfar-Saba, Israel

REPRODUCTIVE FUNCTIONS OF THE AGEING MALE Do semen parameters show age-dependent alterations? Is there a male contribution to reduced fertility and fecundity of older couples? Is there a genetic risk for offspring attributable to increased paternal age?

Fertility of ageing male Facts that are to be taken in consideration when analyzing male fertility: 1. Basically, fertility in men persists well into old age 2. There is a strong female age effect that influences fertility in couples 3. With aging, coital frequencies are reduced, incidence of ED is increased, 4. Accumulated influences of certain habits like smoking, alcohol, etc.

Fertility of ageing male In a study from Britain the odds ratio for conception within 12 months decreases by 3% per year of the men’s age. * But, men’s age was evaluated at conception = paternal age may be overestimated. Hassan and Killick found that men >45y are 4.6-fold more likely to have a time to pregnancy (TTP) of >1y relative to men aged <25y.Results remain similar when restricted to young women. (Ford 2000, Sallmen 2001, Hassan 2003)

Miscarriage risk for couples in different age groups (a retrospective study)

Age related changes in clinical pregnancy probability (a prospective study by Dunson et al. 2002 )

Paternal age and assisted reproduction The more invasive the treatment, the less important male age appears. Success rate of ICSI or IVF are not associated with male age. Spandorfer 1998, Piette 1990, Gallardo 1996, Paulson 2001 Success rate of IUI is related to male age Mathieu 1995, Brzechffa 1997