We hear a lot about women’s biological clock and how age affects the chance of pregnancy.

New research shows men’s fertility is also affected by age. When dads are over 50, the risk of pregnancy complications increases.

Data from more than 46 million births in the United States between 2011 and 2022 compared fathers in their 30s with fathers in their 50s.

While taking into account the age of the mother and other factors known to affect pregnancy outcomes, the researchers found every ten-year increase in paternal age was linked to more complications.

The researchers found that compared to couples where the father was aged 30–39, for couples where the dad was in his 50s, there was a:

• 16% increased risk of preterm birth
• 14% increased risk of low birth weight
• 13% increase in gestational diabetes.

The older fathers were also twice as likely to have used assisted reproductive technology, including IVF, to conceive than their younger counterparts.

Dads are getting older

In this US study, the mean age of all fathers increased from 30.8 years in 2011 to 32.1 years in 2022.

In that same period, the proportion of men aged 50 years or older fathering a child increased from 1.1% to 1.3%.

We don’t know the proportion of men over 50 years who father children in Australia, but data shows the average age of fathers has increased.

In 1975 the median age of Australian dads was 28.6 years. This jumped to 33.7 years in 2022.

How male age affects getting pregnant

As we know from media reports of celebrity dads, men produce sperm from puberty throughout life and can father children well into old age.

However, there is a noticeable decline in sperm quality from about age 40.

Female partners of older men take longer to achieve pregnancy than those with younger partners.

A study of the effect of male age on time to pregnancy showed women with male partners aged 45 or older were almost five times more likely to take more than a year to conceive compared to those with partners aged 25 or under. More than three quarters (76.8%) of men under the age of 25 years impregnated their female partners within six months, compared with just over half (52.9%) of men over the age of 45.

Pooled data from ten studies showed that partners of older men are also more likely to experience miscarriage. Compared to couples where the male was aged 25 to 29 years, paternal age over 45 years increased the risk of miscarriage by 43%.

Older men are more likely to need IVF

Outcomes of assisted reproductive technology, such as IVF, are also influenced by the age of the male partner.

A review of studies in couples using assisted reproductive technologies found paternal age under 40 years reduced the risk of miscarriage by about 25% compared to couples with men aged over 40.

Having a male under 40 years also almost doubled the chance of a live birth per treatment cycle. With a man over 40, 17.6% of treatment rounds resulted in a live birth, compared to 28.4% when the male was under 40.

How does male age affect the health outcomes of children?

As a result of age-related changes in sperm DNA, the children of older fathers have increased risk of a number of conditions. Autism, schizophrenia, bipolar disorders and leukaemia have been linked to the father’s advanced years.

A review of studies assessing the impact of advanced paternal age reported that children of older fathers have increased rates of psychiatric disease and behavioural impairments.

But while the increased risk of adverse health outcomes linked to older paternal age is real, the magnitude of the effect is modest. It’s important to remember that an increase in a very small risk is still a small risk and most children of older fathers are born healthy and develop well.

Improving your health can improve your fertility

In addition to the effects of older age, some chronic conditions that affect fertility and reproductive outcomes become more common as men get older. They include obesity and diabetes which affect sperm quality by lowering testosterone levels.

While we can’t change our age, some lifestyle factors that increase the risk of pregnancy complications and reduce fertility, can be tackled. They include:

• smoking
• recreational drug taking
• anabolic steroid use
• heavy alcohol consumption.

Get the facts about the male biological clock

Research shows men want children as much as women do. And most men want at least two children.

Yet most men lack knowledge about the limitations of female and male fertility and overestimate the chance of getting pregnant, with and without assisted reproductive technologies.

We need better public education, starting at school, to improve awareness of the impact of male and female age on reproductive outcomes and help people have healthy babies.

For men wanting to improve their chance of conceiving, the government-funded sites Healthy Male and Your Fertility are a good place to start. These offer evidence-based and accessible information about reproductive health, and tips to improve your reproductive health and give your children the best start in life.

Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Common medicines used to treat conditions including heartburn, reflux, indigestion and stomach ulcers may be the subject of a class action lawsuit in Australia.

Lawyers are exploring whether long-term use of these over-the-counter and prescription drugs are linked to stomach cancer or kidney disease.

The potential class action follows the settlement of a related multi-million dollar lawsuit in the United States. Last year, international pharmaceutical company AstraZeneca settled for US$425 million (A$637 million) after patients made the case that two of its drugs caused significant and potentially life-threatening side effects.

Specifically, patients claimed the company’s drugs Nexium (esomeprazole) and Prilosec (omeprazole) increased the risk of kidney damage.

Which drugs are involved in Australia?

The class of drugs we’re talking about are “proton pump inhibitors” (sometimes called PPIs). In the case of the Australian potential class action, lawyers are investigating:

• Nexium (esomeprazole)
• Losec, Asimax (omeprazole)
• Somac (pantoprazole)
• Pariet (rabeprazole)
• Zoton (lansoprazole).

Depending on their strength and quantity, these medicines are available over-the-counter in pharmacies or by prescription.

They have been available in Australia for more than 20 years and are in the top ten medicines dispensed through the Pharmaceutical Benefits Scheme.

They are used to treat conditions exacerbated by stomach acid. These include heartburn, gastric reflux and indigestion. They work by blocking the protein responsible for pumping acid into the stomach.

These drugs are also prescribed with antibiotics to treat the bacterium Helicobacter pylori, which causes stomach ulcers and stomach cancer.

What do we know about the risks?

Appropriate use of proton pump inhibitors plays an important role in treating several serious digestive problems. Like all medicines, there are risks associated with their use depending on how much and how long they are used.

When proton pump inhibitors are used appropriately for the short-term treatment of stomach problems, they are generally well tolerated, safe and effective.

Their risks are mostly associated with long-term use (using them for more than a year) due to the negative effects from having reduced levels of stomach acid. In elderly people, these include an increased risk of gut and respiratory tract infections, nutrient deficiencies and fractures. Long-term use of these drugs in elderly people has also been associated with an increased risk of dementia.

In children, there is an increased risk of serious infection associated with using these drugs, regardless of how long they are used.

How about the cancer and kidney risk?

Currently, the Australian consumer medicine information sheets that come with the medicines, like this one for esomeprazole, do not list stomach cancer or kidney injury as a risk associated with using proton pump inhibitors.

So what does the evidence say about the risk?

Over the past few years, there have been large studies based on observing people in the general population who have used proton pump inhibitors. These studies have found people who take them are almost two times more likely to develop stomach cancer and 1.7 times more likely to develop chronic kidney disease when compared with people who are not taking them.

In particular, these studies report that users of the drugs lansoprazole and pantoprazole have about a three to four times higher risk than non-users of developing chronic kidney disease.

While these observational studies show a link between using the drugs and these outcomes, we cannot say from this evidence that one causes the other.

What can I do if I’m worried?

Several digestive conditions, especially reflux and heartburn, may benefit from simple dietary and lifestyle changes. But the overall evidence for these is not strong and how well they work varies between individuals.

But it may help to avoid large meals within two to three hours before bed, and reduce your intake of fatty food, alcohol and coffee. Eating slowly and getting your weight down if you are overweight may also help your symptoms.

There are also medications other than proton pump inhibitors that can be used for heartburn, reflux and stomach ulcers.

These include over-the-counter antacids (such as Gaviscon and Mylanta), which work by neutralising the acidic environment of the stomach.

Alternatives for prescription drugs include nizatidine and famotidine. These work by blocking histamine receptors in the stomach, which decreases stomach acid production.

If you are concerned about your use of proton pump inhibitors it is important to speak with your doctor or pharmacist before you stop using them. That’s because when you have been using them for a while, stopping them may result in increased or “rebound” acid production.

Nial Wheate, Professor and Director – Academic Excellence, Macquarie University; Joanna Harnett, Senior Lecturer – Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, and Wai-Jo Jocelin Chan, Pharmacist and Associate Lecturer, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.