Consumer text discusses infertility and how it relates to men of all ages. Covers the biological clock and shows how it applies to men as well as women and covers testosterone levels during various stages of life.

Introduction The Silent Epidemic

1

(17)

The Male Biological Clock

18

(20)

The Truth About Testosterone

38

(26)

Viagra Generation

64

(23)

Infertility: Not Just a Woman's Problem

87

(38)

Finding Sperm When a Man Is ``Sterile''

125

(16)

Slowing the Biological Clock: A Guide to Sexual Health

141

(11)

Working as a Team

152

(14)

Appendix Finding Help

166

(2)

Notes

168

(4)

Acknowledgments

172

(1)

Index

173

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Introduction: The Silent Epidemic Say "biological clock," and most people think "women." Most people know that a woman's ovaries stop producing eggs at some point and that natural fertility ends with menopause. But conventional wisdom holds that men can father children as easily at seventy-five as at twenty-five. Stories of people such as Saul Bellow, who became a father at age eighty-five, and Tony Randall, a father at seventy-two, help sustain a widespread myth: women have a gun to their heads that men never have to face.Unfortunately, the conventional wisdom is wrong. Men have biological clocks too. This fundamental fact about life has been very slow to reach the public for many reasons, not least because an entire industry has arisen in the past decade for "fixing" female infertility with high-tech procedures such as in vitro fertilization (IVF). By and large, treating female infertility is much more financially lucrative than treating male infertility. The focus (by both women and their doctors) on the female side of infertility, and the urgency with which many couples come to the fertility industry, combine to shove male infertility to the sidelines and to launch couples into IVF prematurely. Sadly, millions of dollars are spent each year on IVF and other sophisticated procedures that could have been avoided if the male side of infertility had been properly diagnosed and treated. Most people -- and even many doctors -- don't know the startling facts about aging, male sexuality, and male infertility, in part because the studies that reveal these facts are so new.The male biological clock isn't like a woman's. It "ticks" at a different rate, it causes an entirely different set of bodily and behavioral changes over the course of a lifetime, and it doesn't strike a "midnight" toll of an absolute end to fertility. But male fertility, testosterone levels, and sexuality all definitely decline with age. Men older than thirty-five are twice as likely to be infertile as men twenty-five or younger. In addition, as men age, the genetic quality of their sperm declines significantly. Every couple should know these facts because they affect two of the most important things in their life: their ability to have children and their capacity to have good sex.The reality of the male biological clock and the ways the ticking of this clock can result in numerous problems with fertility or sexuality are facts that have not yet reached the men and women on the street. On the contrary: myths about male infertility and sexuality abound. Here are the myths I come across most often. 1. Infertility is rare and is mostly a women's problem.Wrong. Each year about 6 million American men and women realize they have a fertility problem. In about 40 percent of these couples the problem lies with the man. In another 40 percent, it's the woman with the problem, and in another 20 percent either both partners contribute or the cause is unknown. Roughly 10 percent of men trying to father a child -- roughly 2.5 million men in the United States alone -- are either infertile or subfertile. Many of these men don't know they have a problem because they haven't been tested; others have been tested but not thoroughly enough. Hence their problem remains undetected and medical attention shifts to the female.2. Although older women are at higher risk of having children with Down syndrome, the man's age doesn't matter.Wrong. Down syndrome is a pattern of mental retardation and altered physical features caused by an extra chromosome 21. It has long been known that a woman's chance of having a baby with Down syndrome rises dramatically after age thirty-five, but it had been thought that the man's age had nothing to do with it. Now we know that this is false -- men also have a higher likelihood of fathering a Down syndrome baby as they get older. The incidence of genetic problems i