January
29th
  6:53:50 PM

Fetal health not only a female affair

While most people are used to considering the female ticking body clock, we tend to think that men have a lot more time.  Though true is one sense, if we want healthy babies maybe they too should be considering the age factor.  An interesting article in the New Republic highlights this issue among many others associated with the rising age of parents – it’s well worth a read.

It has long been known that the risk that a pregnancy will yield a trisomy, such as downs syndrome, rises astronomically as a woman heads towards to her forties.  However, Judith Shulevitz, a first time mother at 37 herself and now concerned by the trend, identifies that new research published this year finds with greater certainty that older men also pass on more genetic mutations to their children.  Birth defects linked to older fathers include dwarfism, Apert syndrome (a bone disorder that may result in an elongated head), Marfan syndrome (a disorder of the connective tissue that results in weirdly tall, skinny bodies), and cleft palates.  The research concludes that the number of genetic mutations that can be acquired from a father increases by two every year of his life, and doubles every 16, so that a 36-year-old man is twice as likely as a 20-year-old to bequeath such mutations to his children.

The detailed article also raises questions about the effect of fertility treatment – another outcome of so many people not trying to have children until their natural fertility is starting to wane.  Shulevitz observes that:

Fertility doctors do a lot of things to sperm and eggs that have not been rigorously tested, including keeping them in liquids (“culture media,” they’re called) teeming with chemicals that may or may not scramble an embryo’s development—no one knows for sure. There just isn’t a lot of data to work with: The fertility industry, which is notoriously under-regulated, does not give the government reports on what happens to the children it produces. As Wendy Chavkin, a professor of obstetrics and population studies at Columbia University’s school of public health, says, “We keep pulling off these technological marvels without the sober tracking of data you’d want to see before these things become widespread all over the world.”

Disturbingly, birth defects have also been associated with the commonly used fertility aid Clomid in a recent New England Journal of Medicine study.  The study’s lead researcher and a professor of pediatrics at the University of Adelaide, Michael Davies, estimates that there may be in excess of 500 preventable major birth defects occurring annually across Australia alone as a direct result of the drug.  Apparently, intracytoplasmic sperm injection is now also being associated with higher rates of birth defects.  Scary stuff when all these procedures are on the rise.

Shulevitz also worries about the effect on children of having older parents that will die much earlier in their lives – especially if they are more likely to be coping with abnormalities such as those mentioned above and may actually need greater parental support.  She uses a term which I haven't heard of before to describe this phenonomom – the ‘sandwich’ generation.  Apparently it describes a new generation that will have to care both for ailing parents and dependent children at the same time – with no help from the grandparents with their children obviously.  While there are no easy solutions to the trend, she suggests the following:

Doctors will have to get out the word about how much male and female fertility wanes after 35; make it clear that fertility treatments work less well with age; warn that tinkering with reproductive material at the very earliest stages of a fetus’s growth may have molecular effects we’re only beginning to understand.

She ends by hoping that her children won’t face the same ‘un-baby-friendly’ career pressures that she had to confront that ended up making her herself wait so long to have children.  Definitely food for thought.



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