Reproductive axis ageing and fertility in men

Compared to women, increasing male age is not accompanied by such marked changes in reproductive function but changes certainly do happen. These include alterations to the hypothalamo-pituitary-testicular axis, with resultant implications for testosterone production and bioavailability as well as spermatogenesis. There is a decline in sexual function as men age, with a dramatic increase in the prevalence of erectile dysfunction after the age of 40, which is a marker for both clinically evident as well as covert coronary artery disease. Despite a quantitative decline in spermatogenesis and reduced fecundability, the male potential for fertility persists throughout adult life, however there are also increasingly recognised alterations in sperm quality and function with significant implications for offspring health. These changes are relevant to both natural and medically assisted conception.

Automated summary

Compared to women, the impact of increasing age on reproductive function in men is not as significant, but changes still occur. These changes include alterations in testosterone production and bioavailability as well as spermatogenesis. As men age, their sexual function and erectile function decline, which may also be related to coronary artery disease. Although there is a decline in spermatogenesis, men have the potential for fertility throughout adulthood, but changes in sperm quality and function may have significant implications for offspring health.