Can We Really Wait Longer to Have Kids?

It's, it's, it's really a numbers game.

And, and you, I think you alluded to this, but biological clock, I think for most people, that's culturally coded female.

Yes.

But there is a biological clock for men as well, no?

Yes.

It is very much a 50/50 equation.

You know, 50% of couples with infertility will have some sort of male factor, whether it be sperm quality issues, not enough sperm, they can't swim in a forward direction.

But men always make new sperm.

Every 74 days, new sperm cells are created, and it's kind of like on a rolling basis.

So when we think about how to improve sperm quality, we typically will retest like three months later 'cause that's when we expect there to be turnover and a change in the results.

But that doesn't mean that men are immune to aging and that they don't have a clock.

It just ticks differently for them, and there's plenty of data now to show, and we haven't yet agreed upon the definition for advanced paternal age, but some studies say like over 45 or over 50.

There is an impact on the quality, and there can be an impact on fertility.

Yes, men can father children even in their 70s, but there can be mutations that are more likely to be passed on to future children through aging sperm.

And there are some studies that have looked at associations between advanced paternal age and an increased incidence of things like autism, neurodevelopmental-

Right

... issues, even childhood cancers.

You know, the overall risk is low, but the, the relative risk when you compare it to younger men is there, and that's something that we should be talking about more because, a- by the way, sperm freezing is actually cheap and easy enough to do.

And I think if a man knows, hey, I'm in my 40s and I don't see myself having children anytime soon, why isn't that an option that's talked about more? So there is a real opportunity, you know, to improve the situation on the male side.

And something that's really interesting in recent data is the suggestion that the placenta, which is this magical organ that forms in early pregnancy and it's the connection between mom and baby, a lot of paternal genes are actually contributing to the functioning of the placenta.

So there have been large scale studies that have looked at male health habits, chronic medical conditions, and they have related it to problems like morning sickness and, you know, high blood pressure in pregnancy, all of the things that can go wrong in pregnancy, and even future health outcomes for their children.

So I talked to my patients about this because I, I think that we need to change the way we think about fertility and really understand that family building is a team sport.