title: Secondary infertility and the aging male, overview.
abstract: BACKGROUND
  Old men preparing themselves for marriage late in their lives might face infertility. Infertility in this group of men should be considered from a wider perspective, as they face any age-related health troubles that include, but are not limited to, androgen deficiency and psychological disorders that impede early conception. This review aims to shed light on the proper approach to this minority of secondarily infertile men.
  
  
  METHODS
  A comprehensive electronic English literature search was conducted, using various medical websites and books, for the factors that cause infertility in senior fathers. The physiology of geriatric males, together with their common comorbidities, were discussed.
  
  
  RESULTS
  Old men presenting with secondary infertility should be approached differently. Aging, itself, has a significant impact on male sexual function, sperm parameters, and fertility; all of which contribute to poor fecundability, decreased fertilizing capacity, increased time to pregnancy, increased rate of DNA damage, high abortion rates and increased prevalence of fetal developmental failures. The complexity and the unknowns of the aging male physiology, together with the interaction of obstinate diseases the patient might have, make the issue very difficult to tackle.
  
  
  CONCLUSIONS
  Management should include the conventional way of treating young sufferers and further target the underlying causes, if known, along with the provision of geriatric, psychologic, and andrologic support.
authors.affiliation: Department of Urology and Department of Andrology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
authors.forename: Atif Abdulhamid
authors.initials: AA
authors.lastname: Katib
authors.affiliation: Department of Urology and Department of Andrology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Hawsawi
authors.affiliation: Department of Urology and Department of Andrology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
authors.forename: Wael
authors.initials: W
authors.lastname: Motair
authors.affiliation: Department of Urology and Department of Andrology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
authors.forename: Abdallah Makhloof
authors.initials: AM
authors.lastname: Bawa
keywords: androgen deficiency; andropause; old men; secondary male infertility; testosterone; varicocele