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Fertilität bei Männern über 40 Jahren

Fertility in men aged 40 and over

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Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Hintergrund

Eine Elternschaft im späteren Lebensalter wird von vielen Menschen als vorteilhaft wahrgenommen, da oft in vielerlei Hinsicht stabilere Lebensbedingungen gegeben sind. Auch gibt es Männer, für die eine zweite Familie eine Lebensoption darstellt. Daher rücken auch biologische Aspekte der älteren Vaterschaft in den wissenschaftlichen und klinischen Fokus.

Altersabhängige Faktoren mit Einfluss auf die männliche Fertilität

Das Alter beeinflusst die männliche Fertilität durch eine Reihe von Faktoren, die in ihrer Gänze nicht komplett verstanden sind. Die Spermienproduktion und -motilität nimmt aufgrund der verfallenden testikulären Feinarchitektur mit zunehmendem Alter ab. Auch nimmt mit dem Alter des Mannes die Fekundität durch weitere Faktoren ab: Ein gestörter Schwangerschaftsverlauf wird oft beobachtet. Einige sehr seltene autosomal-dominante Erkrankungen sind deutlich mit dem väterlichen Alter assoziiert.

Epigenetische Effekte

Hinzu kommen epigenetische Effekte, die mit neurokognitiven Störungen und möglicherweise sogar metabolischen Dysbalancen vergesellschaftet sind. Solche Effekte können sich, einmal ausgelöst, offensichtlich über mehrere Generationen erstrecken. Dabei wird ein Alter des Mannes über 40 Jahre bereits als biologischer Einflussfaktor angesehen, der möglicherweise jedoch durch ein jüngeres Alter der Partnerin ausgeglichen werden kann – zumindest in Teilaspekten. Eine entsprechende Beratung sollte auf jeden Fall patientenorientiert sein. Statistische Wahrscheinlichkeiten sind gegen individuelle Wünsche abzuwägen.

Abstract

Background

Parenting in later life is perceived by many as advantageous because more stable living conditions are often possible. In addition, this gives men the option to have a second family. Therefore, biological aspects of becoming a father later in life have become the focus of scientific and clinical research.

Age-dependent factors influencing male fertility

Age affects male fertility by a number of factors that are not yet completely understood. Generally, the amount of produced spermatozoa as well as their motility decrease with advancing age, and testicular histological architecture deteriorates. This results in decreased fecundity and also an increased risk for difficult pregnancies with advancing paternal age. Some rare autosomal dominant diseases are associated with paternal age.

Epigenetic effects

Dysbalanced patterns of epigenetics and gene expression in aging sperm seem to affect a range of neurocognitive disorders across generations. A man’s age older than 40 years is viewed as a biological factor which may, however, be —at least partially—compensated by a younger female partner. Nevertheless, counseling of older fathers-to-be must be patient-oriented and statistical probabilities must be weighed against individual wishes and life-planning.

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Interessenkonflikt. M. Zitzmann gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinikum Münster, Domagkstr. 11, 48149, Münster, Deutschland

    M. Zitzmann MD, PhD

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Zitzmann, M. Fertilität bei Männern über 40 Jahren. Gynäkologische Endokrinologie 12, 16–20 (2014). https://doi.org/10.1007/s10304-013-0581-3

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