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13/09/2022 - 6 min read

The one in twenty men affected by sperm inefficiency

Care Team

"I have heard it time and time again from men on the roller coaster ride of fertility treatment – that their role, presence and feelings, when compared with those of their women co-pilots, are at best side lined, at worst ignored" Ripping up the Script is an entertaining read about fertility. "The more men’s voices are out there, the easier it will become for us to talk about it.” (Gareth Down, founder of Men’s Fertility Support.)

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It’s hugely important that men can find the confidence to get fully involved in their partner’s and perhaps their own fertility issues. Fertility has for too long been seen as mostly a women’s issue.
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Charles Kingsland, fertility expert

We all know it’s hard for men to talk about infertility given what’s at stake – their masculinity, social standing, that chip off the old block not happening. ‘Strong, silent, provider’ is a deeply engrained code of honour. And there are other factors too, that are holding men back from being more involved when it comes to matters fertility. With the risk of making one or two gender-based generalisations, and with assurances that I know, having watched my wife go through it, just how life-shattering the whole fertility thing is for women – here’s some thoughts on this subject.

It’s a strange state of affairs, when you think about it. Because when it comes to infertility, around 50% of causes are male-factor traced (a little known and talked about fact in itself).

Once a man’s sperm is proved to be sufficiently active and mobile, and he’s had his moment in the sample room, then of course he has to take a necessary step back. It’s his partner’s stage now, everything happens to her: drugs; mood swings, retrieval and implantation, DIY jabs and all. But he’s still just as emotionally charged and vulnerable as she is.

Sure, if you’re amongst the 1 in 20 men affected by sperm inefficiency, then of course you’re under the initial spotlight (only an unfortunate 1 in 100 men has an absence of sperm altogether, a condition known as Azoospermia). But these men too, once they’re through their rounds of tests and treatments, give exactly the same evidence when it comes to feeling like a spare part.

Surely there is reason and room for change here, as men experience the highs and lows of their shared cycle, all that waiting, preparation, treatment and result? Clinics, HCPs, counsellors – everyone, family and close supporters included. They all need to do more to engage and empower men around the treatment so that they really do co-own and share that cycle. After all, it is just as much theirs; a life changing several weeks, months and quite often years for them too.

My own fertility trip is over, at least the coal-face years of it (it never quite goes away, that biological, heart-felt tug of the sleeve that every now and again steps out of the shadows). After four failed rounds of IVF – the first three with London’s ARGC and then a final role of the dice in Las Vegas – we retired exhausted and wounded from the fertility front. After a break, as we reflected on my wife’s diminishing egg quality and her suspected immunology issues, we considered and rejected both donor-egg and surrogacy. And after another break, we got used to the idea of adoption, then signed up for the home study. Eventually, some nine years after the initial, de-railing discovery of our infertility, we were placed with our infant son. A momentous day, and several bonkers years later (family life!), it’s been a pretty good story, for all of us. (I’m a big fan of adoption and always happy to talk about our experiences.)

More recently, I pitched myself back into the world of fertility when I wrote a book about it. There were several reasons for writing it, not least to boost my own understanding and acceptance around that long stage of our lives. But also, because very little of what I found to read on fertility was written by men, exploring the subject from a male perspective. Books, forums, clinic chat groups, articles across a whole range of publications, print and online – nearly all of the content written by women. So, I thought, given that around 50% of the 1 in 7 couples finding it tough to conceive were men, there’s got to be some readers out there.

The book is for men and women going through it all, but where it feels right, I have purposefully landed on the maleness of the journey – mine, and many others.

Some of that male territory is more obvious (predictable, perhaps!). For example, a few stories from the porn-strewn confines of the sample room. One from a work colleague who dreaded his solo mission so much he smuggled his partner in there to help him out. And when one day she wasn’t available, he fled the clinic and managed to book himself and his jar into a Travel Lodge, for free. And a chase story – a man whose wife tracked him down on an overseas work trip to phone him with the news that she was ovulating and, much to his surprise, was ready and waiting in his hotel room. There’s much humour amongst the spills and thrills of a fertility journey – the more we can lighten its considerable load, the better.

It also covers male-orientated experiences and events of a more sensitive nature. Sex (not surprisingly) features strongly: how fertility issues have a way of shredding our once treasured sex lives like nothing else. Other differences, tensions and issues that we find driving wedges between us. What happens between men and women, when they need to be at their strongest and most together, when they are taken to the very limits of what humans can possibly bear and eventually live with? Several men generously contribute their stories. It is, by all accounts (mine included), a perfect shit-storm to find yourself caught up in. But going quiet, as men do, is the worst way to deal with it. Instead of tackling the loss and grief-like sadness together, a couple can drift, lock each other out, eventually part. The book covers what we can do to help ourselves, and our partners, to become (despite everything) a stronger couple for it. Counselling is the obvious help-at-hand, but there are plenty of self-help tools in the box too.

Today, thankfully, there are lights at the end of tunnels for men going through it. Right across the health landscape, from Prostate Cancer to that hot potato mental health, silence and stigma are turning to talk and support. A Face Book group, for example, called ‘Men’s fertility support – a secure place for men only to talk’. How brilliant that there’s now such a group for men to share their hopes, fears and experiences, to support each other through their losses, and on red-letter days, to celebrate their good news

Onwards! With thanks to Care Fertility for providing this platform and wishing everyone the best possible outcomes on their roller coaster rides – both men and women, together". Gareth Downs, Founder of Men's Fertility Support