The Risks to Babies of Older Fathers (Published 2019) (2023)


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Personal Health

Most women know that reproductive risks to themselves and their babies rise as they get older, but few men realize that their advancing years may also confer a risk.

The Risks to Babies of Older Fathers (Published 2019) (1)

The Risks to Babies of Older Fathers (Published 2019) (2)

By Jane E. Brody

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People are becoming parents at ever-increasing ages, a trend that can have implications for the health of the pregnancy, the babies and the women who birth them.

But while most women know that reproductive risks to themselves and their babies rise as they get older, few men past 40 realize that their advancing years may also confer a risk.

The age at which couples start families has been rising steadily for the last four decades as more couples marry later and delay having children until they’ve completed their education and are secure in their careers.

Whereas a woman’s clock typically slows in her 30s and runs down by age 50 or so, it can go on ticking almost indefinitely for a man. Witness these celebrities — George Clooney, Hugh Grant, Steve Martin, David Letterman and John Stamos — who became first-time dads in their 50s or beyond.

Since the 1970s the percentage of births to fathers aged 40 or older in this country has doubled, and by 2015 they accounted for 9 percent of births.

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“For so many years, it was assumed that advancing age only mattered for women,” Hilary K. Brown, a researcher in reproductive public health at the University of Toronto, said. “Paternal age matters as well.”

A recent study of more than 40.5 million births in the United States revealed potentially harmful effects of advanced paternal age on a baby’s risk of prematurity, low birth weight, low Apgar score and risk of seizures, as well as the mother’s chances of developing gestational diabetes.

The study, published in BMJ and directed by Dr. Michael L. Eisenberg, a urologist and head of male reproductive medicine and surgery at Stanford University School of Medicine, concluded that “more than 12 percent of births to fathers aged 45 years or older with adverse outcomes might have been prevented were the fathers younger.”

Dr. Eisenberg, Dr. Yash S. Khandwala and colleagues found that fathers older than 45 had a 14 percent greater chance than fathers in their 20s and 30s of their babies being born prematurely and at low birth weight. The mothers too faced a 28 percent increased risk of gestational diabetes. As the fathers’ ages rose, their babies were more likely to need help with breathing and require admission to the neonatal intensive care unit.

The risks associated with older fathers go beyond those obvious at birth. An earlier review of studies published by Dr. Eisenberg and Dr. Simon L. Conti, clinical assistant professor of urology at Stanford, linked paternal aging to an increased risk of babies born with congenital diseases like dwarfism or developing psychiatric disorders like schizophrenia and bipolar disorder and developmental ones like autism.

For example, a study of nearly 400,000 men and women born in Israel in the 1980s found that among fathers older than 40, the risk of having a child with autism increased nearly sixfold. Other studies found that the risks of childhood leukemia, breast and prostate cancers were elevated among offspring of older fathers.

Lots of attention has been paid to the risks women face by delaying pregnancy beyond, say, age 35, but men have not been privy to comparable concerns about their fertility and possible health effects on a pregnancy or the children they father. Older mothers are typically meticulously screened for possible risks to a healthy pregnancy “while the father’s role in childbirth is often ignored or forgotten,” Drs. Eisenberg and Khandwala wrote.

Although the risks of fathering a child in one’s 50s, 60s and 70s are not huge, the recent studies have shown there are sometimes significant long-term societal as well as personal consequences.

The challenges start with getting pregnant, which often takes longer when prospective fathers are older, Dr. Eisenberg told me. “Fertility is a team sport, and the runway for men is not unlimited,” Dr. Eisenberg said. A woman hoping to become pregnant by an older man might want to know “how good are your swimmers?” a question that can be answered by a semen analysis.

“The ability to father a child declines as men get older,” he said. “Semen quality diminishes — volume lessens with age and the motility and shape of sperm decline a little.” Such changes reduce the ability of a man’s sperm to fertilize an egg.

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There are a number of possible reasons older fathers may impart health risks to unborn babies. Unlike women, who are born with all the eggs they will ever produce, after puberty men continuously produce new sperm. Mutations can occur and accumulate in the DNA of sperm-forming cells, and environmental exposures can change the genes in sperm themselves. Some of those changes can affect growth factors for both the placenta and the embryo, Dr. Eisenberg and colleagues suggested.

“There needs to be a greater awareness of the man’s responsibility to reproductive health,” Dr. Brown said, adding that this responsibility starts with a man’s “preconception health — factors like obesity, chronic disease and behaviors like smoking and alcohol consumption that could affect the health of a pregnancy.”

“Given that close to half of pregnancies are unplanned, men can’t afford to wait to get healthy until they’re ready to have a baby.”

She added, “While it makes sense to delay reproduction to accommodate educational and career goals, couples should have full access to the risks and benefits of having children now or later. A man’s age has not been a typical part of the conversation.”

In an editorial accompanying the report on 40.5 million births, Dr. Brown emphasized that “current findings underscore the importance of including, in reproductive life plans, discussions of paternal age and declines in sperm quality.”

She suggested that doctors emphasize the need for everyone of reproductive age — future fathers and mothers alike — to adopt healthy lifestyles that can “pay off in a number of ways, not just in having a healthy pregnancy but also in preventing chronic disease. Physicians should be having these conversations with men, not just women.”

Of course, there can be significant advantages to having children sometime later in life than in one’s teens or twenties, maturity and financial security of the parents among them. Older parents may also have more time and patience to nurture their children.


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What are the risks to babies of older fathers? ›

On the other hand, old fathers (≥ 40 years) could increase risks of cardiovascular abnormalities, facial deformities, urogenital abnormalities, and chromosome disorders in their offspring.

What is the risk of birth defects by paternal age? ›

There is no doubt that, older fathers are more likely to have infant with birth defects, stillbirth and low birthweight (18-22). An Italian study, conducted during the period 1990-1998 revealed that men aged 45 to 49 years had a higher risk of having a pre-term birth, than men aged 25 to 29 years (23).

What age is considered high risk pregnancy for father? ›

Generally speaking, the older a father's age, the greater the risk. For example, men who were 45 or older were 14 percent more likely to have a child born prematurely, and men 50 or older were 28 percent more likely to have a child that required admission to the neonatal intensive care unit.

Can a 60 year old man impregnate a woman? ›

Although a man's fertility can theoretically last until death, sperm production has been found to decline from around the age of 50. Although it is still possible to conceive a child, and many men do have children in their 50s or later, it may take longer for you and your partner to become pregnant.

Does father's age affect Down syndrome? ›

Fisch and his colleagues found that the rate of Down syndrome steadily increased with advancing paternal age for the maternal age group of 35 to 39 years. The greatest increase, however, was seen in the maternal age group of 40 years and older with increasing paternal age.

Can old men father healthy babies? ›

In short, yes (Harris 2019, NICE 2013). Although most men are able to have children well into their 50s and beyond, it becomes gradually more difficult after the age of 40 . There are many reasons for this, including: Sperm quality tends to decrease with age.

What birth defects come from the father? ›

Some studies have linked increasing paternal age (over 40 or so years) with higher rates of conditions like autism and schizophrenia. Others have observed increased rates of birth abnormalities, such as heart defects, musculoskeletal abnormalities, and Down's syndrome. Mouse studies also support this.

Does the man's age matter in pregnancy? ›

The risks of pregnancy complications increase as women age. Male fertility decline is more subtle, but a man's age affects the chances of his (female) partner conceiving. Male age over 45 years increases the risk of miscarriage, and the child's risk of mental health and developmental disorders.

Do birth defects come from the mom or dad? ›

For their children to get the disease, they have to inherit a defect in the same gene from both parents. The risk that the mother and the father both have the same genetic defect and that it will result in disease is usually small, but it increases when parents are blood relatives.

What is the safest age range to have a baby? ›

Your fertility naturally declines as you get older, which could make it harder for you to conceive. And starting a family later in life could pose greater risks for pregnancy complications. Experts say the best time to get pregnant is between your late 20s and early 30s.

Who are the high risk babies? ›

What are high-risk infants? Doctors refer to babies who are born prematurely or who are sick when they are born as high-risk infants. This means they have a high risk of short and long-term health and developmental challenges.

What age is considered old for a man? ›

In America, one researcher found that you are considered old at 70 to 71 years of age for men and 73 to 73 for women.

How much sperm does a 70 year old man produce? ›

RESULTS: Older men had lower semen volume (mean semen volume 1.8 versus 3.2 ml; P <0.0001) and total sperm output (median 74 versus 206 million sperm per ejaculate; P <0.0001), whereas sperm density (median 64 versus 73 million sperm/ml; P =0.12) was non-significantly decreased.

At what age does sperm quality decline? ›

Age and sperm

Most men make millions of new sperm every day, but men older than 40 have fewer healthy sperm than younger men. The amount of semen (the fluid that contains sperm) and sperm motility (ability to move towards an egg) decrease continually between the ages of 20 and 80.

Which parent carries Down syndrome? ›

In the majority of cases, the extra copy of chromosome 21 comes from the mother in the egg. In a small percentage (less than 5%) of cases, the extra copy of chromosome 21 comes from the father through the sperm. In the remaining cases, the error occurs after fertilization, as the embryo grows.

What is the chance of Down syndrome after 40? ›

Risks for chromosome abnormalities by maternal age

The chance of having a child affected by Down syndrome increases from about 1 in 1,250 for a woman who conceives at age 25, to about 1 in 100 for a woman who conceives at age 40.

What genetic disorders are common in advanced paternal age? ›

Several genetic diseases that occur with a low frequency in the general population are associated with advanced paternal age. These include Apert, Crouzon and Pfeiffer syndromes, achondroplasia and other conditions (75).

Can men over 50 have healthy babies? ›

There are plenty of men who, after the age of 50, have had healthy children. Until a link between paternal age and disorders is established, I wouldn't advise patients not to have children over 50 simply because of age.

Are older men more likely to father daughters? ›

The scientists also note that at the age of 35, the proportion of sperm carrying an X chromosome also seems to increase, meaning older dads are more likely to have daughters. In human reproduction, the Y chromosome is responsible for making a male child.

What is inherited from father only? ›

All men inherit a Y chromosome from their father, which means all traits that are only found on the Y chromosome come from dad, not mom.

What does the baby get from Dad? ›

To form a fetus, an egg from the mother and sperm from the father come together. The egg and sperm each have one half of a set of chromosomes. The egg and sperm together give the baby the full set of chromosomes. So, half the baby's DNA comes from the mother and half comes from the father.

What does the baby take from the father? ›

A baby gets 23 chromosomes from his mother and 23 from his father. With all the possible gene combinations, one pair of parents has the potential to produce 64 trillion different children. This probably gives you an idea of how impossible it is to predict just what your baby will look like.

What age is a man's sperm most fertile? ›

Age and Male Fertility

Peak male fertility is around 25-29 years old. Sperm quality begins to decline at 30. At 45, men begin to experience a significant decrease in semen volume. Older men can also take longer to conceive a child.

Who is your closest blood relative? ›

List of who your nearest relative is
  • Husband, wife or civil partner (including cohabitee for more than 6 months).
  • Son or daughter.
  • Father or mother (an unmarried father must have parental responsibility in order to be nearest relative)
  • Brother or sister.
  • Grandparent.
  • Grandchild.
  • Uncle or aunt.
  • Nephew or niece.

What are the 4 main causes of birth defects? ›

Smoking, drinking alcohol, or taking certain drugs during pregnancy. Having certain medical conditions, such as being obese or having uncontrolled diabetes before and during pregnancy. Taking certain medications, such as isotretinoin (a drug used to treat severe acne). Having someone in your family with a birth defect.

How many babies can a woman have in her lifetime? ›

One study estimated a woman can have around 15-30 children in a lifetime, taking pregnancy and recovery time into account. Since men require less time and fewer resources to have kids, the most "prolific" fathers today can have up to about 200 children.

How does the father's age affect sperm cells? ›

Several other retrospective studies have shown a relation between sperm parameters and age and reported lower semen volume, lower progressive motility and percentage of normal morphology in older men compared to younger men [45-47].

What age is it harder for men to have kids? ›

Age and sperm

Men younger than 40 have a better chance of fathering a child than those older than 40. The quality of the sperm men produce seems to decline as they get older. Most men make millions of new sperm every day, but men older than 40 have fewer healthy sperm than younger men.

What age do most men have first child? ›

The average age men become fathers is 27.4. The average age women become mothers is 24, consistent with findings from the U.S. Census Bureau (2011). Men, on average, are three years older than women when they become parents. This gap has remained fairly stable over the past two decades.

What is the oldest age of a father? ›

The oldest ever man to father a child was reportedly Les Colley (1898 - 1998, Australia), who had his ninth child a son named Oswald to his third wife at the age of 92 years 10 months.

Can birth defects be caused by the father? ›

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. A father does not share a blood connection with a pregnancy, so medications or chemicals that are in their blood stream do not reach the developing baby.

What is the best biological age to have a baby? ›

Experts say the best time to get pregnant is between your late 20s and early 30s. This age range is associated with the best outcomes for both you and your baby. One study pinpointed the ideal age to give birth to a first child as 30.5. Your age is just one factor that should go into your decision to get pregnant.


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