Male Infertility: Breaking the Stereotypes and Seeking Solutions

Male Infertility: Breaking the Stereotypes and Seeking Solutions

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6 mins

Infertility now affects a staggering 1 in 6 people worldwide. Historically, it’s been seen as strictly a women’s issue, and as a result, most infertility advice is aimed at women.

But the truth is that up to 50% of all cases in which a couple can’t conceive is due to male infertility, according to the American Society for Reproductive Medicine.

Despite this alarming statistic, men experiencing infertility do not receive adequate care or have enough support when it comes to these reproductive challenges.

To recognize World Fertility Awareness Month this June, we’re taking a deep dive into why men have less help when it comes to infertility and how they can get the resources and guidance they need to navigate this often lonely and challenging road.

Insufficient social support for male infertility

Because it's been labelled a women's issue for so long, women have had more time to come to terms with infertility and create community groups to help share experiences and coping strategies with one another.

The issue of infertility is a less taboo subject among women who are becoming more vocal and open about their struggles. Forums, online and in-person discussion groups and Facebook communities are rife with advice, support and guidance for women undergoing these fertility challenges.

But even though they face the same financial, emotional, mental and marital strain, men experiencing infertility don’t have this same support network. Many female-focused groups on Facebook boast active membership in the tens of thousands, while men's-only groups are few and far between, have fewer members and are less active on average.

Traditional gender norms around masculinity likely play a part, where men feel ashamed and emasculated by their inability to reproduce. Research shows that men often find opening up about these struggles and making themselves vulnerable can be a real hit to their ego, which is why so many choose to suffer in silence.

Another reason men are less likely to seek mental health support or voice their struggles is that they often feel guilty if their partner is bearing the physical toll of the infertility experience.

Whatever the reason, the lack of social support for men experiencing infertility is hugely problematic. From a psychological perspective, we know that social support and commiserating with others can help significantly reduce the negative emotional and mental impact of infertility.

A lack of reproductive urologists (RU)

Women tend to be more in-tune with their reproductive health from a young age, which includes having routine check-ups with GPs, appointments with gynecologists and regular cervical screenings. When potential fertility-related issues do arise, women are often referred to a reproductive endocrinologist (RE) for specialized follow-up.

But even though 12% of men aged 25-44 experience some form of infertility, they aren’t expected to be as involved in their own fertility health. In fact, many have never met with a reproductive urologist (RU), nor do they understand the role they can play in screening for fertility issues. In fact, there is a scarcity of RUs in the US right now: only 200 practices in the country compared to around 1300 REs.

This lack of specialized support for men’s fertility issues is likely another reason many of those experiencing infertility don’t get adequate medical care for their reproductive health.

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The ticking of men’s biological clock

There is a misconception that only women deal with declining infertility as they age. In a recent Australian study, one in four respondents believed that male fertility only starts to diminish at 50 or later.

In fact, both men and women experience the same type of fertility decline after 35. For women, their egg count and egg quality decreases, and for men, their body starts producing fewer and less viable sperm.

This erroneous belief that men can have children whenever they want leads many to avoid taking proactive measures to assess the health of their fertility, and it’s also a likely culprit for a lack of support services available to men experiencing infertility.

The many factors influencing male infertility

Over the past 40 years, sperm count has declined more than 50% among men living in Western countries, according to a 2017 study published in the journal Human Reproduction Update.

And while no definitive answer has been found for this profound drop (though some scientists think they have figured it out), there are a number of significant factors that can negatively impact male fertility rates, such as:

Environmental (like the prevalence of herbicides, pesticides, toxins, and microplastics)

Lifestyle (sedentary lifestyles can play a part, as well as excessive exercise, stress, heavy alcohol consumption and occupational hazards)

Drugs and medication (both recreational drugs like marijuana, and performance-enhancing drugs like steroids, as well as prescription medication used to treat conditions like depression, anxiety, ADHD and autism)

Medical history (including genetic diseases, known or unknown blockages in reproductive organs, past surgeries, STDs and weight)

How men can take control of their reproductive health

Like most advice regarding our health, taking a proactive approach to your fertility is always the best course of action.

If you’re a man who knows it’s important that you start a family at some point in your life, it’s worth getting screened as early as possible, ideally in your mid-twenties to early thirties.

These screenings can include hormone testing, semen analysis and medical examinations that look into your medical history and lifestyle.

For those looking for more discrete ways to test, there are popular at-home semen analysis kits from Hera, as well as companies like Legacy that also offer semen freezing, which is another option to discuss with your care provider.

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