One in six people face fertility issues in the UK. National Fertility Awareness Week begins on 30 October and provides an excellent opportunity to highlight the impact that infertility has on many people, not only in the UK but around the world.
While many people assume that infertility primarily affects women, an estimated 50% of infertility cases are caused by male factors. Unfortunately, societal misconceptions and stigmatisation have led to a lack of open and honest conversations on this topic. This stigma has been perpetuated through incorrect terminology and societal pressures. For example, many people generally refer to all fertility treatment as ‘IVF’, which assumes a female factor and is only one of many procedures in the field of medically assisted reproduction. By increasing understanding and encouraging empathy, we can break the stigma and empower men to address their fertility concerns.
The causes of fertility issues in men are varied. Male infertility can result from a defect in the production of testosterone (2-5% of cases), sperm transport disorders (5% of cases), abnormal sperm parameters (65-80% of cases) or be idiopathic (10-20% of cases). In addition, external factors including age, obesity, smoking and even air pollution can have significant effects on male fertility. Studies have shown that anxiety and stress caused by infertility can directly affect testosterone levels and spermatogenesis. These feelings exacerbate the issue leading to low libido and erectile dysfunction resulting in a profound psychological effect on these men. It is vital that we improve our understanding of men’s health to ensure that men facing these issues feel more confident discussing their fertility with healthcare providers.
The emotional impact of infertility is often overlooked. Men who are diagnosed with fertility issues report feeling a sense of loss, stigma and low self-esteem. In a study of 15 men who had experienced infertility issues, one participant described feeling like ‘less of a man’ for being unable to impregnate their partner and described the ability to father a child as a ‘goal to your existence’, showing the fundamental importance of this goal to some men.
In addition, participants described feeling dismissed from the treatment process by their care providers and reported feeling a sense of blame. Many even lacked a support system to confide their worries in, with their families being unsupportive, uncaring and uncomfortable discussing the issue.
The way we discuss these issues can be emasculating and prevent men from seeking help. Healthcare providers also need to be more sensitive and avoid making light of male infertility. It is important to break the stigma surrounding male infertility and to create a safe and supportive environment for men to discuss their fertility issues.
This Fertility Awareness Week, let’s do better in the way we talk about men’s health and foster open discussions with care and sensitivity. By promoting dialogue, education and empathy, we can support individuals affected by infertility and empower them to seek the help they need.
References are available on request.
