It is now well recognised that male infertility is a factor in 50% of couples who have difficulty in conceiving, but that doesn’t mean that this fact has permeated fully into western public consciousness. Research shows that men’s needs are largely unmet in terms of evaluation of the condition, mental help services such as counselling, and other resources such as online help. Where available, informational websites and printed information for men are primarily geared toward female-factor infertility, and support groups geared toward men experiencing infertility are practically nonexistent.
Research funded by the American Society for Reproductive Medicine (ASRM)* has found that feelings of grief and loss related to the inability to have a family were common to males as well as females. But men also reported problems communicating with their female partners, leading to emotional isolation.
Part of this male reaction may be due to subtle psycho-social gender nuances, as the researchers found that with female-factor infertility men viewed their primary role as problem solvers, like knights in shining armour! However, with male-factor infertility, men reported frequent self-blame, loss of manhood, and feelings of guilt and isolation.
In addition, men in the study frequently experienced barriers to treatment. All participants, male and female, in the research reported frustration with the lack of information about male infertility, difficulty finding reputable websites pertaining to male reproductive health, and scarcity of male reproductive health specialists.
There are a number of issues, which come into play here:
* Men are sometimes not evaluated for infertility at the same time as their female partner. This potentially wastes time, if the actual problem lies with the male and money if the female undergoes expensive tests when the problem lies with the male
* Addressing only one partner at a time is problematic because it potentially ascribes blame to whichever partner is found to be infertile. It is clear that, for a healthy relationship to be sustained for both partners, the journey towards bearing a child and overcoming any obstacles on the way should be a team effort from the start
* When men are found to be infertile, there is very little available to them in terms of support as previously noted. This is very important because some issues of male infertility may be easy to address
Recognising this situation in the US, ASRM guidelines recommend that men and women should be evaluated at the same time. According to Professor Peter Schlegel, President of the ASRM, the society is now moving toward better communication with men and improving its website to make information geared toward men more visible.
Professor Schlegel said, “There really is a limited amount of evaluation typically done of men prior to treatment. Even the most severe male infertility conditions when sperm production is so low that no sperm appear in the ejaculate can be safely and effective treated.”
The ASRM-funded research concludes that, because men experience female-factor infertility differently from male-factor infertility, there is a need for specific support services geared toward the male partner.
Normalising the experience of male infertility, improving access to care for men and developing easily-understood educational materials is a priority to allow males suffering from infertility to become informed participants in their treatment journeys.
In the meantime, it is important to understand where couples first experience issues with fertility and that men should not be excluded from a journey that ideally should be undertaken with their female partners from the start.
For more information:
*American Urological Association (AUA) 2019 Annual Meeting: Abstract PD29-04. Presented May 4, 2019