I do feel some sympathy-as I would with any person who is looking back on their life with any regrets-however it is somewhat limited.
It's limited because he admits that having/wanting children only became a focus in his early 40s. So, he assumed, during his 20s/30s, that he had all the time in the world and that when he was finally ready-he would find someone young enough and fertile enough to have kids with.
It would be one thing if he'd been trying to find the right woman to settle down with during the optimum years-and it just hadn't happened-but the fact that the issue of children didn't even occur to him until his early 40s speaks of his entitlement and dare I say it-delusion.
He fully believed that when the time came-a young, fertile woman would be more than happy to bear his kids. This is the message that is spread to young men from the media and the "manosphere." Many young, lonely men are following red-pill commentators, soaking up their advice which is largely "women are to blame for everything that is wrong in your life," "feminism has destroyed society," "women hit the wall as soon as they hit 30" and "men remain endlessly attractive to women and have their pick of women even when they get older."
The delusion is that because men have a wider and longer fertility window than women do-that means they can put off settling down and having children indefinitely. What society neglects to tell them is that whilst their fertility may remain (it declines past 40) their ability to attract young, fertile women withers and dies. Unless they fall into the categories of-status (fame), wealthy (high value) and good-looking (this is optional depending on how wealthy/famous a man is).
Vast majority of men don't fall into those categories, yet they want the perks of being in the "club" without putting in any of the work to get into the "club."
Of course, that isn't the case for every man who finds himself in similar situations. There are men and women who, for one reason or another, it just didn't happen.
As far as the "I don't want to be old and alone," references-and the discussion there-life comes with no guarantees. I'm child-free by choice, and it's not something that I'm worried about.
Having a child isn't a guaranteed way to have a carer or even an advocate. They could move to another country and be unable to advocate for you. You could have a shitty relationship with them and you don't speak. They could end up in prison.
You could have a child that has additional needs or disabilities that renders them incapable of being your carer/advocate. In fact, in this instance, there may be some issues surrounding how their care/needs are met in the case of their parent passing on or being incapable of providing care as they age.