Men can father children well into later life, but sperm quality does decline with age. What changes after 45, what you can do about it and when to get tested.
Every few months a headline announces that men’s sperm counts are collapsing and humanity is doomed. Meanwhile Mick Jagger became a father again at 73. Both stories are, in their way, true, and neither tells you much about your own chances.
If you’re 45-plus and thinking about a child, perhaps with a younger partner or in a second family, it’s worth knowing what really happens to fertility as men get older. The short version: you don’t hit a cliff, but you are on a slope.
Yes, though slowly. Unlike women, men don’t go through a fertility shutdown. You keep making sperm for life. But from around your late thirties onwards, research consistently finds that semen volume, sperm movement (motility) and the proportion of normally shaped sperm tend to drift downwards.
The more interesting change is in what you can’t see under a microscope. Older sperm carry more DNA damage and more new genetic mutations, because the cells that make them have been dividing for decades and errors build up. Laboratory work is also starting to show age-related changes in the proteins inside sperm, which may help explain why older men’s sperm don’t perform as well in fertility treatment.
In practice, this means it may take longer for a couple to conceive when the man is older, even after allowing for the woman’s age. Studies also link older fathers with a somewhat higher risk of miscarriage and a small rise in the risk of certain conditions in children, including some rare genetic disorders, autism and schizophrenia. The rise is real but small in absolute terms. Most children of older fathers are perfectly healthy.
A major analysis published in 2022, pooling studies from around the world, concluded that average sperm concentrations had more than halved since the 1970s. It made headlines everywhere, and with good reason.
The picture is messier than the headlines, though. Counting methods have changed over the decades, the men studied in the 1970s weren’t always comparable with men studied now, and some researchers dispute how much of the fall is real. Possible culprits under investigation include obesity, smoking, chemical exposures and sedentary lifestyles, but none has been nailed down as the main cause.
The more useful point for you is this: a population average says very little about an individual. Your own count could be well above or well below it, and the only way to know is to test.
Your age is the one thing you can’t change about your sperm. Almost everything else that matters, you can.
The good news is that sperm are constantly being replaced. It takes roughly three months for a new batch to develop, so changes you make now show up in your semen in about a season. The NHS advice for men trying to conceive is unglamorous but sensible.
Stop smoking. Tobacco is linked to poorer sperm quality, and the effect is one of the better established.
Watch the drink. The UK Chief Medical Officers’ advice is to keep to no more than 14 units a week, spread over several days. Heavy drinking can reduce sperm quality and lower your libido too, which doesn’t help.
Shift some weight if you need to. Carrying excess fat, particularly around the middle, is associated with lower testosterone and poorer sperm. Even a modest loss can help.
Keep things cool. The testicles hang outside the body for a reason: sperm production works best a little below body temperature. Loose underwear, not resting a laptop on your lap for hours and going easy on long hot baths and saunas are all reasonable precautions.
Move more. Regular exercise helps weight, mood and hormone levels. Cycling has been blamed for fertility problems, but the evidence is weak. Comfortable shorts and a decent saddle should do it.
Fertility supplements for men, usually antioxidant mixes containing things like zinc, selenium, vitamin E and coenzyme Q10, are widely sold. The evidence that they lead to more pregnancies is limited and mixed. They’re unlikely to harm you at normal doses, but don’t expect them to cancel out smoking or a diet of takeaways. Ask a pharmacist if you’re on other medicines.
This one catches a lot of midlife men out. Testosterone replacement therapy, whether prescribed or bought online, can sharply reduce sperm production. Adding testosterone from outside tells the brain to stop sending the hormonal signals that drive the testicles, and sperm production can fall to very low levels or stop altogether.
The same goes, more severely, for anabolic steroids used for bodybuilding. Recovery after stopping is common but not guaranteed, and it can take many months.
So if you’re taking testosterone, or thinking about it, and you might want a child, raise it with your GP or specialist before you start or change anything. Don’t stop a prescribed treatment on your own. Other medicines can affect sperm too, so it’s worth mentioning any you take.
If you and your partner have been trying for a year without success, NICE guidance says you should both be offered fertility checks on the NHS. If your partner is 36 or older, or either of you has a known reason to suspect a problem, it’s sensible to see your GP sooner rather than waiting the full year.
For men, the first step is usually a semen analysis. Your GP can refer you, and you’ll be asked to abstain from ejaculating for a few days beforehand, then produce a sample at the clinic or at home for quick delivery. If the result is abnormal, NICE recommends a repeat test, ideally around three months later, because results naturally vary.
You can also pay for a test at a private fertility clinic, with prices typically around £150 to £300 depending on the clinic and what’s included. Home sperm test kits are cheaper, but most measure only sperm concentration or basic movement, so treat a reassuring result with some caution.
If you need fertility treatment, check the Human Fertilisation and Embryology Authority (HFEA), the UK regulator, which lists licensed clinics and explains the options. NHS funding for treatment such as IVF differs between England, Scotland, Wales and Northern Ireland, and in England it can vary by local area. If you’re thinking of becoming a father later, sperm freezing is also possible at HFEA-licensed clinics, usually privately.
And if you notice a lump, swelling or pain in a testicle, don’t wait for a fertility appointment. See your GP promptly. For urgent advice, call NHS 111.
Men can father children into later life, but after about 45 sperm quality gradually declines, conception can take longer and there’s a small rise in some risks for the pregnancy and child. You can’t change your age, but stopping smoking, drinking moderately, losing excess weight and keeping cool all help, and testosterone treatment can seriously reduce sperm production. If you’ve been trying for a year, or sooner if your partner is 36 or older, ask your GP about a semen analysis, or pay for one privately.
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