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availability of assisted reproductive technologies (ARTs), simple declines in semen analysis, or even remote vasectomy, are obstacles that are simple to overcome. There is currently no clear consensus for the definition of APA, which makes a meaningful clinical discussion challenging and analysis of previous data very difficult. Many studies typically define APA as 35–50 years of age, whereas others have taken to stratifying APA into 5-year brackets.7 One could argue that moving forward, research on male fertility should include some type of breakdown of the data into male age subpopulations. Counseling regarding the risks of APA should still be conducted with all couples. Conti and Eisenberg5 nicely highlight the increased relative risks of autism, schizophrenia and bipolar disease in APA; however, the absolute risks remain quite low. Nevertheless, Andrologists should develop a personal response to questions that patients will have about cryopreservation at a younger age to prevent the negative effects of aging. Given that there are published reports of successful pregnancies following sperm cryopreservation of up to 28 years,8 the practice of freezing one’s sperm at a younger age will no doubt be getting further attention in the future.

The role of advanced paternal age in modern reproductive medicine