title: Infertile men older than 40 years are at higher risk of sperm DNA damage.
abstract: BACKGROUND
  The effect of paternal age on semen quality is controversial. In this retrospective study, the aim was to investigate the effects of advancing age on sperm parameters including reactive oxygen species (ROS), total antioxidant capacity (TAC) and sperm DNA damage in infertile men. We also examined whether paternal age >40 y is associated with higher risk of sperm DNA damage.
  
  
  METHODS
  A total of 472 infertile men presenting for infertility were divided into 4 age groups: group A: patients ≤ 30 y; group B: patients 31- 40 y, group C: ≤ 40 y and group D: patients >40 y. The following tests were performed - semen analysis according to WHO 2010 criteria, seminal ROS by chemiluminescence, TAC by colorimetric assay and sperm DNA damage by TUNEL assay - and the results were compared amongst the 4 age groups.
  
  
  RESULTS
  There was no statistical difference in conventional semen parameters, TAC and ROS with advancing paternal age as well as between different age groups. However, a significant negative association was noted between sperm DNA damage and advancing paternal age. Men >40 y showed higher levels of sperm DNA damage (24.4 ± 18.5%) compared to younger men (<30 y; 16.7 ± 11.2%; p <0.05).
  
  
  CONCLUSIONS
  Infertile men over the age of 40 y have a greater percentage of sperm DNA fragmentation compared to infertile men aged 40 y and below. Advanced paternal age (>40 y) may increase the risk of sperm DNA damage in infertile men.
authors.forename: Saad
authors.initials: S
authors.lastname: Alshahrani
authors.affiliation: Glickman Urological and Kidney Institute, Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA. agarwaa@ccf.org.
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
authors.forename: Mourad
authors.initials: M
authors.lastname: Assidi
authors.forename: Adel M
authors.initials: AM
authors.lastname: Abuzenadah
authors.forename: Damayanthi
authors.initials: D
authors.lastname: Durairajanayagam
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayaz
authors.forename: Rakesh
authors.initials: R
authors.lastname: Sharma
authors.forename: Edmund
authors.initials: E
authors.lastname: Sabanegh
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking; D000975:Antioxidants / Q000378:metabolism; D004249:DNA Damage; D006801:Humans; D007248:Infertility, Male / Q000150:complications / Q000235:genetics* / Q000378:metabolism; D008297:Male; D017382:Reactive Oxygen Species / Q000378:metabolism; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D055101:Semen Analysis / Q000379:methods; D012907:Smoking; D013094:Spermatozoa / Q000378:metabolism*; D014646:Varicocele / Q000150:complications
chemical_list: D000975:Antioxidants; D017382:Reactive Oxygen Species