Will our age gap be something to worry about when we decide to get pregnant?
January 11, 2010 3:57 PM   Subscribe

Will our age gap be something to worry about when we decide to get pregnant?

My partner and I, a heterosexual couple, are a decade apart in age, and we expect that this relationship will result in marriage and children. It will be years before I am ready for kids, and I'm concerned that by that time, my partner will be an older-than-average father (I will not be an older mother, due to the age gap), and I've read some research that this could contribute to a higher risk of birth defects.

Is this something we should be seriously concerned with, enough so that I should consider having children sooner? Would it be worth it for our peace of mind to store his sperm now, and forgo natural conception for a more clinical, but less risky conception?
posted by anonymous to Health & Fitness (28 answers total) 4 users marked this as a favorite
 
My understanding is that advanced age of the father doesn't represent any significant risk of birth defects.

I think you may be confusing this with something else: advanced age in the mother yields a huge increase in the risk of chromosomal defects. But there is no equivalent risk for men.
posted by Chocolate Pickle at 4:00 PM on January 11, 2010


In addition to CPs comment, my understanding is the biggest factor in preventing birth defects (other than, try not to be 47 or live above a toxic waste dump) is adequate consumption of folic acid on the part of the mother.
posted by A Terrible Llama at 4:02 PM on January 11, 2010


My understanding is that advanced age of the father doesn't represent any significant risk of birth defects.

I take it you haven't read this NYT article?
posted by Jaltcoh at 4:03 PM on January 11, 2010 [3 favorites]


A lot of defects can be detected in-utero. What you do if you detect one becomes a separate problem.
posted by GuyZero at 4:05 PM on January 11, 2010


Don't worry. Men have children into their 70s. Look at Larry King (he probably shouldn't have, but still)...Sure, sperm deteriorate with age, but I'd be more concerned if you were the one a decade older than your SO, as it's the women with more of a window, and more likely to have at risk pregnancies/chance of birth defects as they get into their 40s...
posted by delladlux at 4:05 PM on January 11, 2010


I concur (though I am not a doctor). I have never heard of any correlation between the father's age and birth defects. Obviously, though, if the father is 50, your ten-year age difference would make you 40, which would give a much higher risk to your children.
posted by Admiral Haddock at 4:06 PM on January 11, 2010


The risk of birth defects does appear to rise with paternal age. But that's what prenatal screening and counseling is for.
posted by Sidhedevil at 4:07 PM on January 11, 2010


How old are we talking about? Is he going to be 90? When I got pregnant with Baby BlahLaLa, I was 35 and Mr. BlahLaLa was 49. We did do some genetic counseling for another reason, and the counselor mentioned that there were certain issues that could arise with an older dad, but nothing they could test for. We had a normal pregnancy and a healthy baby.

Unless you have other genetic issues to deal with, I think this falls into the category of "you just never know," part of the vagaries of dealing with fertility for pretty much everyone.
posted by BlahLaLa at 4:08 PM on January 11, 2010


There are plenty of other things to stress about when pregnant or considering pregnancy. I wouldn't place this anywhere near in the top ten. Not that one data point really matter but my husband was 47 when I got pregnant and no one suggested that I be concerned in the least.
posted by otherwordlyglow at 4:09 PM on January 11, 2010 [1 favorite]


Chocolate Pickle and Admiral Haddock, you aren't being helpful - just because you're not aware of something doesn't mean it doesn't exist.

OP, there is a greater risk of infertility and birth defects as men age. How much greater the risk is, I don't know. I would talk to your ob/gyn or a reproductive endocrinologist.
posted by amro at 4:10 PM on January 11, 2010 [6 favorites]


More articles about the risks of advanced paternal age here and here.
posted by Sidhedevil at 4:16 PM on January 11, 2010


The age of the father actually is a contributing factor to both ability to get pregnant and the health of the offspring, although not as much as the age of the mother. As an example, the risk of achondroplasia can be up to ten times higher for a father over forty (although the absolute risk is still very low) because achondroplasia is cased by a very specific point mutation that occurs in the fgfr3 gene within the sperm DNA, a mutation which becomes more likely to happen as you age.

Again, the overall risk is very low but I mention this to point out that all those saying they've never heard of a link between paternal age and birth defects are wrong, or maybe right in that they've never heard of it but regardless, the links are there. Either way the advice that follows such a statement is ill-informed. Whether advance paternal age has any noticeable effect is unclear, but it's worth considering even if you decide not to worry about it further. Here's an article which discusses the issue.

Things you need to consider are would storing the sperm long term have any effect on it's viability of DNA integrity? (I have no idea on this one). Do either of you have any predispositions or genetic backgrounds which might make a generally very low risk higher for you and your partner? Are there other issues in your life that make waiting/not waiting more feasible? Prenatal screening doesn't make the problem go away, just gives you more options (some of which you may find personally distasteful) to deal with it should a defect or whatever occur.

I think the best way to address all this is talk with your doctor, presumably your gynaecologist although a family doctor can certainly help, and get some better informed and more personalised information about your situation, then go from there. I have friends who've talked to their doctors about possible future children, even ones not in a long term relationship, so it's definitely a normal and reasonable conversation to have (I've never done it only because I don't want kids).
posted by shelleycat at 4:25 PM on January 11, 2010 [2 favorites]


There's a simple answer here: have him donate sperm for storage. My father-in-law did this before getting a vasectomy, and his latest ex-wife encouraged him to do it "just in case he changed his mind when he got older." Which he did, and he has two fantastic twin boys to show for it. Then, later in life when you attempt to do this, your concerns can be alleviated by a test, and if there are issues the stored sperm can be used.
posted by davejay at 4:26 PM on January 11, 2010


Yes, what shelleycat and amro said. Talk with your GYN and your partner's urologist, who should be up to date in the latest studies. Or the two of you could meet with a genetic or fertility counselor.

The Statement on Guidance for Genetic Counseling in Advanced Paternal Age might be a good starting point to organize your thoughts.
posted by Sidhedevil at 4:30 PM on January 11, 2010 [1 favorite]


Re: freezing sperm: Most IVF docs won't use sperm that is more than seven years old (some set the limit lower, like at five years) so that's something to consider. I think the record for a successful human pregnancy with frozen sperm was twelve years.
posted by Sidhedevil at 4:32 PM on January 11, 2010


Then, later in life when you attempt to do this, your concerns can be alleviated by a test

Except, as has been pointed out, at least some of the problems with older sperm can't be identified by a test. For example, the achondroplasia mutation I mentioned occurs in that one single sperm. Every other sperm in there can be good, so a negative, or even positive, test for this mutation doesn't really help with knowing what's going on in the sperm which is going to contribute to the baby.

Which is why talking with a Dr will be a good idea. They (or a genetic councillor they refer you to) should have better information about what can and can't be tested for, what the risks are for you guys specifically as a couple, and the utility of various methods for dealing with the problem.
posted by shelleycat at 4:33 PM on January 11, 2010


As a dad, the only age cap that I was concerned about was making sure that birth+22 years was less than an age where my statistical chances of being dead were still reasonably low.

As it stands... I figure I can give him at least 10 years of adult-aged embarrassment before he has enough evidence to claim legal guardianship...

And I can definitely say - I know for an absolute fact - 10 years from now there's no way I would want to be trying to chase after a toddler...


Do you want to risk walking your child down the aisle alone?
posted by Nanukthedog at 4:35 PM on January 11, 2010


Sidhedevil's link doesn't work me; try this one: The American College of Medical Genetics cites an linearly increasing risk in the offspring of men over age 40 for conditions due to new mutations in their 2007 statement on advanced paternal age here and states most of these will not be prenatally detectable by standard technology.
posted by beaning at 4:36 PM on January 11, 2010


Thanks, beaning! That was the very document I was trying to link to.
posted by Sidhedevil at 4:45 PM on January 11, 2010


The American College of Medical Genetics cites an linearly increasing risk in the offspring of men over age 40 for conditions due to new mutations in their 2007 statement on advanced paternal age here and states most of these will not be prenatally detectable by standard technology.

Many of the conditions listed in that document are very, very rare compared to the conditions that can be detected. There is very little point in worrying about Marfan syndrome, statistically speaking.
posted by GuyZero at 5:03 PM on January 11, 2010


[few comments removed - question is not about "what should I be concerned about" not nitpicking about who does or does not want to be born.]
posted by jessamyn (staff) at 5:22 PM on January 11, 2010


While GuyZero is correct in that the individual disorders are rare, collectively they present an increased risk above and beyond the general population and this risk further rises when advanced paternal age data for non-neonatal conditions such as schizophrenia and autism are included.

Thus leading to the numerous comments above that anonymous and her partner should consider talking with an expert about what *they as a couple* find acceptable for risks, options, and outcomes. It's much preferable to spend some time and money in advance rather than finding out mid-pregnancy that prenatal screening indicates that the 1 in 1000 chance for some genetic condition is more like 1 in 100 for you, and having no previous idea that your partner felt *that* way about the situation.

And, I'd recommend that consultation be with a genetic counselor rather than your OB or gyn, or at least that they determine in advance if the OB or gyn is comfortable and current in their expertise on the rapidly changing prenatal genetics field. A certified genetic counselor who specializes in prenatal/preconceptual issues can easily spend 45-60 minutes reviewing family history and various preconceptual/prenatal screening issues with an eye towards teasing out a mutually comfortable approach for a couple.
posted by beaning at 5:59 PM on January 11, 2010


There is no reason you can't consult an ob/gyn or reproductive endocrinologist or what was the name of the specialist we consulted? A perinatologist, who specializes in high-risk pregnancies. Full of useful information, we found!

If you did become concerned about your partner's age being a problem when you do decide to get pregnant, having children sooner is one option. Another might be freezing some of his young, vital sperm and then doing inter-uterine insemination when you are ready.

I see somebody already mentioned that up-thread. It's something to think about, certainly. Again, consulting with an ob or RE would be a good step. In our experience, REs are happy to meet with you and discuss your situation.
posted by not that girl at 6:03 PM on January 11, 2010


In addition to everything else... you can't know if he has dodgy sperm currently. Traditionally infertility was attributed to women, largely. We now know that a fair percentage of infertility comes from men.

And older sperm contributes to miscarriage.

You should get a moderator to mention the age we're talking about. Or talk to a fertility doctor.

Just because some men have fathered healthy children when they're elderly, doesn't mean your partner will be able to. Friends of mine had a hyper healthy late 40s known donor for ivf and he had such dodgy semen they had to do a special procedure to assist conception.

I"m in favour of the freezing semen idea. Or having a few rounds of ivf and freezing embryos.
posted by taff at 6:17 PM on January 11, 2010


Nthing the advice to talk to a doctor -- starting with your OB-GYN, and see if she recommends speaking further to someone more specialized. Interestingly, though, your decade-wide age gap may mirror a similar gap in the ages when men versus women start to see their offspring's risk of genetic defects rise significantly. Though the American College of Medical Genetics' guidance paper says there's no definite age for advanced paternal age, they also say: "Some studies have suggested that the risk of genetic defects ... is 4-5 times greater for fathers aged 45 and above than for their 20-25 year old counterparts." For women, I think 35 is the beginning of the real zone of concern for genetic defects. So maybe it's the ideal age gap!
posted by palliser at 6:45 PM on January 11, 2010


Do you want to risk walking your child down the aisle alone?

Oh come on. That's not fair. Things happen in people's lives. The fear of one parent not being there to help the other parent is more realistic in this situation but we don't know for sure that's even a reasonable thing, and shouldn't factor into the decision. You don't even know if the baby grows up into a person who even wants to get married or has the opportunity.
posted by anniecat at 9:38 AM on January 12, 2010 [1 favorite]


Yeah, my parents didn't wait until their 40's to conceive (27/31) and I'll be going down the aisle alone anyway. Parents can die at any freaking time regardless of age. That's a stupid reason to hold off, sorry. Ten years isn't nearly as bad as the Larry King situation anyway.
posted by jenfullmoon at 1:02 PM on January 12, 2010


I'm 25, and (soon-to-be) Mr. Pies turned 38 yesterday. Our wedding's a few months away. This is something that we, too, initially had concerns about, since I don't quite feel ready for kids, and we'd both rather be married a while before we even try, anyways. Eventually, though, we concluded that having kids before we're ready would put an unnecessary strain on our relationship. To us, the potential deterioration of our relationship is a greater risk than the very minimal (albeit present) risks presented my conceiving a child with an older man. Just our $0.02.
posted by pecanpies at 8:49 PM on January 13, 2010


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