Not just mom, father's age too matters in child outcome: Docs
TIMES Special Malathy.Iyer@timesofindia.com 05.01.2025
Mumbai : Age is a crucial factor for women keen on motherhood, but what about men? Hollywood veteran Robert De Niro welcomed a baby girl at 79 while 64-year-old British actor Hugh Grant became a father for the first time at 51 years of age. Emerging scientific research now suggests a connection between advanced paternal age and pregnancy outcomes and genetic mutations in children
Doctors plan to discuss the link between paternal age and newborn health during the upcoming Federation of Obstetric and Gynecological Society of India (FOGSI) conference later this week in Mumbai. "While studies haven't shown any genetic abnormality due to paternal age so far, a few have linked it to genetic mutations that could increase the risk of the child having autism, childhood cancers, or adult onset of schizophrenia," said infertility specialist Dr. Ameet Patki. The male factor — sperm count and quality — is responsible for about 30% of infertility cases and an additional 20% as a contributing cause, but paternal age is rarely considered an issue, said Dr Patki, who, as the President of the Indian Society for Assisted Reproduction, has raised this issue at multiple doctors' meetings. "When a woman goes to an infertility expert, she is advised to lose weight or counseled to freeze her eggs, but we never ask men to get fit or freeze their sperm," he said.
Infertility specialist Dr Hrishikesh Pai, who is the outgoing president of FOGSI, said paternal aging has not been a major topic of research, but it's linked to a higher incidence of attention deficit hyperactivity disorder and autism among the offspring. "There is a clear association between maternal age and Down syndrome in an offspring," said Dr Pai. At maternal age 20 to 24, the probability of conceiving a child with Down Syndrome is 1 in 2,000; at age 35 to 39, the probability increases to 1 in 200; and above age 45, the probability increases to 1 in 50. “However, there is no such clear association shown so far with the father's age,” he said. Infertility affects roughly 10% to 12% of all married couples, and technological advancements in infertility treatment have improved the chances of pregnancy for such couples. Now, doctors want an aging want-to-be-a-father's sperm DNA tested for fragmentation. Put simply, a sperm DNA fragmentation test measures the amount of damaged DNA in a sperm sample. As sperm mature, they lose the ability to repair DNA damage caused by multiple factors such as diseases or lifestyle habits such as smoking; the damage or “breaks” hence continue and could negatively influence an older man's reproductive health.
"Sperm DNA fragmentation refers to damage in the genetic material of sperm, which can affect fertility and embryo development," said Dr Ranjith Ramasamy, consultant urologist at Jumeirah American Clinic in Dubai. A study he conducted when he was the director of reproductive urology at the University of Miami in 2021 showed that while sperm count may not decline with age, sperm quality often worsens due to decreased DNA repair capacity. “This highlights the importance of assessing sperm quality in older men, as it may impact reproductive outcomes,” Dr Ramasamy told TOI in an email.
Dr Pai said that sperm DNA fragmentation is now conducted by infertility specialists in India. "In the West, such tests are costly and are only advised when a woman suffers repeated IVF failures," he said. Dr Patki said in a study he conducted a few years back of 100 men undergoing IVF treatment, 60% of the men who had abnormal sperm count also had DNA fragmentation. "Normally, men with a normal count would not be asked to undergo advanced tests, but our study underlined the need to check the fragmentation factor, especially among older men of, say, over 45 who want to be fathers," he said. In India, the ART rules allow IVF treatment for men up to 55 years of age
He asked the husband of one of his patients — a 30-year-old artist who could not conceive for a year — to undergo the fragmentation test. The 48-year-old husband's results showed 70% damage or 'breaks' in the DNA, while the permissible limit is 25%. The man was further tested for other health problems and turned out to be severely diabetic. After months of taking medications, including anti-diabetic pills, antioxidants, and vitamins, the 'break' reduced to 40%, and the couple could conceive through the most basic infertility treatment called IUI or intrauterine insemination (in which the sperm is placed into the uterus to increase the chances of fertilization).
