Ask an Expert: Fatherhood after 50

Q. “I’m a 55-year-old male who is thinking about becoming a father. Does my age present any risks to the baby? My wife is 41. We are both in excellent health.”

Answer from Angela Keating, M.D., board-certified obstetrician/gynecologist with Providence Medical Group Columbia Women’s Clinic:

There is a chance that your age could pose an increased risk of fertility challenges, as well as slightly higher risks of miscarriage and fetal problems. How high a chance, however, is hard to say. The medical literature offers excellent data on older mothers, but provides much less conclusive information on older fathers.

What does seem clear is that the increase in these age-related risks begins much later for men than for women. Your wife’s age might actually be the more significant factor in weighing your pregnancy risks as a couple. For information on the risks of advanced maternal age, we recommend you read our earlier column on Pregnancy Past 40.

Now, back to you. Here is a little bit more information on the types of risks your age might (and might not) present:

Fertility risk: Male fertility does decline with age, but it does so much more slowly and gradually than female fertility. As men age, their semen volume, sperm motility (i.e., swimming skills), and ratio of normal-to-abnormal sperm all decline slowly. Advancing age also may bring health conditions that can affect fertility, such as endocrine dysfunction, testicular dysfunction, erectile dysfunction and sperm outlet obstruction. In general, however, men experience a less definitive drop in fertility than women do, and there doesn’t seem to be an absolute age at which a man can no longer father a child.

Miscarriage risk: There may be a slight increase in the risk of miscarriages as paternal age increases, but this association seems to occur much later in men and is less significant than in women.

The risk of chromosomal abnormalities: Some studies show no difference in the risk of chromosomal abnormalities in fetuses with older fathers, while others show a slightly increased risk. Advanced paternal age also may slightly increase the risk of mutations during the development of the fertilized egg, which can cause autosomal dominant diseases such as Huntington’s disease and polycystic kidney disease.

Give it your best shot

Since both you and your wife are over 35, we recommend that you have a consultation with your health care provider or with a reproductive specialist before you start trying for a pregnancy. This may rule out preventable issues that could reduce your chances of achieving or maintaining a pregnancy. If you try for six months and your wife still hasn’t conceived, schedule a follow-up consultation.

During this time, it will be especially important for both of you to maintain good health and to optimize the treatment of any medical conditions that you have. Talk with your provider about your medical conditions and about any medications that you take. You also should inform your health care provider of any exposure to pesticides, radiation, tobacco or illegal drugs that could affect your sperm quality and count. Finally, stay in close contact with your medical providers throughout this process.

Even though the information on paternal age is very limited, the possibility of associated fetal problems has led The American Society for Reproductive Medicine to recommend that sperm donors be less than 40 years old. As a 55-year-old man who wants to father his own child, however, the potential, slight increase in risk may play less into your final decision than this important statistic: the majority of men your age are able to father a healthy child.

We wish you and your family good luck and good health.

December 2007

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