This month's Views and Reviews examines the current literature on modifiable factors that men can do to optimize reproductive health. Gaskins et al. provide an overview of dietary factors, including ...specific foods, diets, and nutrients associated with male fertility. Service et al. then provided an update on body mass index, weight loss, and male reproduction. Garabed et al. examine the data behind medications using the Anatomical Therapeutic Chemical Classification System. Mínguez-Alarcón et al. reviewed data on chemical exposures and male fertility. Overall, the goal of the section is to allow providers with up-to-date evidence to counsel our patients on factors they can seek or avoid.
Can a father be too old? Eisenberg, Michael L
Fertility and sterility,
12/2022, Volume:
118, Issue:
6
Journal Article
Peer reviewed
This month's Views and Reviews examines the current evidence regarding the association between a man's age and his reproductive health. Wood and Goriely review the link between paternal age and de ...novo mutations. Zweifel and Woodward expand on the implications to the offspring of older fathers by exploring the neurodevelopmental syndromes that become more prevalent in children of older fathers. Finally, Jimbo et al. examines the association between paternal age and several measures of male fertility including semen quality, birth rates, and assisted reproductive technology success rates.
This month's Views and Reviews provides an added perspective to the World Health Organization laboratory manual for the examination and processing of human semen, which was recently published in the ...6th edition. The first artice provides a historical context of the prior editions of the World Health Organization manuals and modifications adopted over the years. The next piece then provides additional perspectives on the methodologies used for the performance of semen analysis. The third article then examines some of the new semen analytic technologies and enhancements that have become more common over the years. Finally, the last article proposed where male reproductive testing will head in the coming years with emerging research and technologies.
The papers in this book present, for the first time, the world of warfare, both defensive and offensive, from the Classical periods to end of the Middle Ages in one collection. These scholarships ...have attracted ancient writers and generals and nowadays historians, archaeologists and researchers poliorcetics. Military historiography and ancient manuals are well familiar from the Classical period throughout the Hellenistic great battlefields until the end of the Middle Ages, the chronological scope of this codex. The current book is the first to encompass this long array of time while trying to enrich the reader with the continuity, development and regression in the different periods and spheres of the ancient poliorcetics and beyond; the papers presented here are focusing on the physical fortifications, besieging and defense techniques, development and efficiency of ancient projectiles and sieging machinery, battlefields and the historiographical evidence. The X papers of the book, are written by some of the best scholars in their field, presenting here for the first time the results of their research, in the west and in the east.
Anogenital distance (AGD), a sexually dimorphic measure of genital development, is a marker for endocrine disruption in animal studies and may be shorter in infant males with genital anomalies. Given ...the correlation between anogenital distance and genital development, we sought to determine if anogenital distance varied in fertile compared to infertile adult men.
A cross sectional study of consecutive men being evaluated for infertility and men with proven fertility was recruited from an andrology clinic. Anogenital distance (the distance from the posterior aspect of the scrotum to the anal verge) and penile length (PL) were measured using digital calipers. ANOVA and linear regression were used to determine correlations between AGD, fatherhood status, and semen analysis parameters (sperm density, motility, and total motile sperm count).
A total of 117 infertile men (mean age: 35.3±17.4) and 56 fertile men (mean age: 44.8±9.7) were recruited. The infertile men possessed significantly shorter mean AGD and PL compared to the fertile controls (AGD: 31.8 vs 44.6 mm, PL: 107.1 vs 119.5 mm, p<0.01). The difference in AGD persisted even after accounting for ethnic and anthropomorphic differences. In addition to fatherhood, on both unadjusted and adjusted linear regression, AGD was significantly correlated with sperm density and total motile sperm count. After adjusting for demographic and reproductive variables, for each 1 cm increase in a man's AGD, the sperm density increases by 4.3 million sperm per mL (95% CI 0.53, 8.09, p = 0.03) and the total motile sperm count increases by 6.0 million sperm (95% CI 1.34, 10.58, p = 0.01). On adjusted analyses, no correlation was seen between penile length and semen parameters.
A longer anogenital distance is associated with fatherhood and may predict normal male reproductive potential. Thus, AGD may provide a novel metric to assess reproductive potential in men.
ABSTRACT
STUDY QUESTION
How has the mean paternal age in the USA changed over the past 4 decades?
SUMMARY ANSWER
The age at which men are fathering children in the USA has been increasing over time, ...although it varies by race, geographic region and paternal education level.
WHAT IS KNOWN ALREADY
While the rise in mean maternal age and its implications for fertility, birth outcomes and public health have been well documented, little is known about paternal characteristics of births within the USA.
STUDY DESIGN, SIZE, DURATION
A retrospective data analysis of paternal age and reporting patterns for 168 867 480 live births within the USA since 1972 was conducted.
PARTICIPANTS/MATERIALS, SETTING, METHODS
All live births within the USA collected through the National Vital Statistics System (NVSS) of the Centers for Disease Control and Prevention (CDC) were evaluated. Inverse probability weighting (IPW) was used to reduce bias due to missing paternal records.
MAIN RESULTS AND THE ROLE OF CHANCE
Mean paternal age has increased over the past 44 years from 27.4 to 30.9 years. College education and Northeastern birth states were associated with higher paternal age. Racial/ethnic differences were also identified, whereby Asian fathers were the oldest and Black fathers were the youngest. The parental age difference (paternal age minus maternal age) has decreased over the past 44 years. Births to Black and Native American mothers were most often lacking paternal data, implying low paternal reporting. Paternal reporting was higher for older and more educated women.
LIMITATIONS, REASONS FOR CAUTION
Although we utilized IPW to reduce the impact of paternal reporting bias, our estimates may still be influenced by the missing data in the NVSS.
WIDER IMPLICATIONS OF THE FINDINGS
Paternal age is rising within the USA among all regions, races and education levels. Given the implications for offspring health and demographic patterns, further research on this trend is warranted.
STUDY FUNDING/COMPETING INTEREST(S)
No funding was received for this study and there are no competing interests.
TRIAL REGISTRATION NUMBER
N/A.
To determine the incidence of chronic medical conditions of men with infertility.
Retrospective cohort study.
Not applicable.
Subjects contained within the Truven Health MarketScan claims database ...from 2001 to 2009.
Not applicable.
The development of chronic medical conditions including hypertension, diabetes, hyperlipidemia, renal disease, pulmonary disease, liver disease, depression, peripheral vascular disease, cerebrovascular disease, heart disease, injury, alcohol abuse, drug abuse, anxiety disorders, and bipolar disorder.
In all, 13,027 men diagnosed with male factor infertility were identified with an additional 23,860 receiving only fertility testing. The average age was 33.1 years for men diagnosed with infertility and 32.8 years for men receiving testing alone. After adjusting for confounding factors, men diagnosed with male factor infertility had a higher risk of developing diabetes (hazard ratio HR 1.30, 95% confidence interval CI 1.10-1.53), ischemic heart disease (HR 1.48, 95% CI 1.19-1.84), alcohol abuse (HR 1.48, 95% CI 1.07-2.05), and drug abuse (1.67, 95% CI 1.06-2.63) compared with men who only received infertility testing. Similar patterns were identified when comparing those with male factor infertility to vasectomized men. The association between male factor infertility and later health outcomes were strongest for men with longer follow-up.
In this cohort of patients in a national insurance database, men diagnosed with male factor infertility had a significantly higher risk of adverse health outcomes in the years after an infertility evaluation. These findings suggest the overall importance of men's reproductive health and warrant additional investigation to understand the association and identify interventions to improve outcomes for these patients.
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