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"What birth defects can we expect?"


I'm a 55-year-old man on methotrexate and my girlfriend is pregnant. What birth defects can we expect.


Thanks for your question, and hopefully the pregnancy is welcome. I recommend that you discuss this question further with your doctor. The good news in your question is that being an older male on medications with potentially negative effects is not as problematic when it comes to birth defects as these same medications and age would be in the mother.

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Part of this can be explained by the fact that, if a sperm is impaired in any way it will be less likely to arrive and fertilize the egg. This means that only the most fit of the sperm will arrive. Over the last few years, however, there have been some ailments that have been traced back to fathers who are somewhat older than average. While this is similar to women who become pregnant when they are older, the risks are significantly less than they are with women. Different authors have suggested that neural tube defects, Down's syndrome, limb defects, and congenital cataracts may be linked to advanced paternal age, but these are, again, much more rare. Likewise, while methotrexate can cause birth defects if being taken by a pregnant mother, the risks are much lower when it is the father who is taking this medication. Please speak with your doctor about this question.

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