Dear Dr Murage,
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You seem to have forgotten men in the fertility equation. I have heard so much about preserving fertility in women, what about us men? My age is advancing rapidly, without any foreseeable prospects of a suitable partner. How do I get my fertility preserved?
You are right, there’s always been an unhealthy balance in addressing male fertility compared to female fertility.
Ideally, the approach should be combined, meaning a couple’s fertility concerns should be addressed with each of the partners being present at the same sitting. There are all sorts of reasons the balance of fertility attention still remains disproportionate between men and women.
Men’s contribution to delays, or failure in conception is in the region of 30 per cent to 40 per cent of all couples who present with fertility concerns. That’s a good enough reason for men to be always part of a fertility assessment.
Equally, the decline in fertility with age in men mirrors that of women. And there are a multitude of conditions that can afflict men and interfere with the potential for future reproduction. It’s therefore reasonable to consider fertility preservation for men who may find themselves in circumstances warranting such a precaution.
As men advance in age, the overall quality of sperms declines. This translates into lower chances of spontaneously fathering a child, and raises the risk of contributing to genetic abnormalities in any conception.
This is more so beyond the fourth decade of life. Ongoing unhealthy lifestyles like use of recreational drugs and being overweight will also contribute to poor sperms quality. Poorly controlled chronic diseases are other factors. If unfortunate to get diagnosed with some form of cancer, treatment with chemotherapy or radiation can damage testicular function and limit future chances of reproduction.
Majority of men will not need to contemplate preserving their fertility. But if you fall into an unfortunate category where preservation is desirable, this should be done when the quality of your sperms is still good. Obvious examples are men who require chemotherapy for whatever reason.
They can get their sperms frozen prior to starting their treatment. Other examples are men who require prostate or testicular surgery, as subsequent sperm production may be affected. Age cannot be completely discounted. If you contemplate reproduction at an unknown time in the future and are well into the fourth decade, you may wish to preserve some sperms as a backup.
Freezing sperms is a well-established science. You will need some preliminary checks and consents, then all you need is to give a semen sample. This is then frozen and kept in storage till its use becomes necessary. Samples can be preserved for years, the sperms’ fertilisation potential remains equivalent to the age at which the freezing was done.
- Dr Alfred Murage is a consultant obstetrician and gynaecologist
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