Prospective Evaluation of Age-Related Changes in Semen Quality among Fertile Men

This study aims to evaluate the effect of age on semen quality in fertile men aged 18–50 years and explore the necessity of age-specific reference ranges. A prospective study was conducted between May 2024 and February 2025 at a tertiary care center, categorizing fertile men into three age groups: 18–30, 31–40, and 41–50 years. Semen samples were analyzed based on WHO guidelines, evaluating volume, sperm count, motility, and morphology. Data were summarized using descriptive statistics, and comparisons between age groups were made with the t-test or Mann–Whitney test. Pearson’s correlation and linear regression were used to assess the relationship between age and semen parameters. A p-value of < 0.05 was considered significant. A total of 150 patients (50 per age group) were included in the study. A significant decline in semen volume, total sperm count, motility, and morphology was observed with advancing age. Men in the 41–50 age group showed significantly lower sperm count and motility compared to younger groups (p < 0.05). Sperm motility decreased notably after age 40, and sperm morphology also declined with age. These findings suggest a potential impact of age on semen parameters, with a noticeable decline in sperm motility and morphology observed particularly after the age of 40 in our study population. Therefore, the development of age-specific reference ranges updated by the WHO will allow for a more accurate assessment of male fertility and serve as an important guide in clinical decision-making processes.