24 Aug 2022 Destigmatizing Male Infertility

While sperm counts in men have dropped drastically over the last 50 years, causing more and more men to face infertility issues, the stigma surrounding male infertility continues to shame men into suffering in silence. Open conversations about infertility in the male community are largely absent, leading to a lack of feeling of shared commonality. The- result is echoed silence with men suffering alone. Why are men still afraid to a talk about infertility when it is more common than ever before?

Perhaps part of the reason for the absence of open conversation is that fertility in men has long been associated with virility and masculinity. Although gender roles have blended in the workforce and at home over time, men still feel a need to provide for their family, and, for many, part of this providing means their ability to procreate. As Paul Flynn, who had been trying for years to conceive with his wife, told The  New York Times, “The fertility specialist informed us I had virtually no sperm. I sat there thinking, ‘I’m a man, I’m supposed to procreate.’ It was a real blow to my self-esteem and who I thought I was.” There is a stigma with men that infertility is a disorder which hinders their ability to be a “man,” so to speak, but in reality male infertility and subfertility (reduced fertility or prolonged time of non-conception) is quite common, and according to ABC News, affects one in 20 Australian men.   

Male Infertility Caused by Health, Lifestyle Choices, Age

Men tend to blame themselves for fertility issues, but I feel it is important to note that, just like women who suffer from infertility, male infertility is no one’s fault. There are several causes for male infertility. Sperm disorders, such as lack of sperm, immature sperm and abnormally shaped sperm, can play a part in infertility as well as structure and flow issues. Infections, immune diseases, scar tissue or genetic issues can be culprits, which is why it is important to get tested and to seek help.

Age also plays a factor with men. At one time, women were thought to be the ones bearing the burden of the biological clock, but it is now evident that men also share the time-ticking clock. According to The New York Times, men over 45 are five times more likely to take a year or more in order to conceive a child with their partner than men who are younger than 45. Dr. Gloria Bachmann, M.D., director of the Women’s Health Institute at Rutgers Robert Wood Johnson Medical School in New Jersey, states, “The older the man is, the more likely his sperm are to have DNA damage that doesn’t make them as potent.” Sperm volume, shape and movement capabilities all decrease with age.

Lifestyle choices also affect fertility, with obesity, smoking, drinking too much alcohol, and having high stress levels topping the list. Sperm counts can increase by maintaining a healthy weight, exercising, and sustaining healthy sleeping and eating habits. Cutting down on smoking and drinking also play a part in the production and quality of sperm. The New York Times states that smokers were “significantly more likely to have low sperm counts and sperm defects” compared with their non-smoking counterparts. Men who had less than five drinks a week also fared much higher with sperm counts. Women have been held to these standards for years with prenatal vitamins and healthy regimens even before they become pregnant. It now seems evident that men, too, need to make lifestyle changes to increase fertility.

Environmental Effects on Male Sperm Count

More recently, fertility experts have recognized the importance of environmental factors on male sperm counts. Toxins, chemicals, radiation, and X- rays all take a toll on sperm, but perhaps most shocking to me is the possible effect of endocrine disrupting chemicals (EDCs). EDCs are found in everything from plastic toys to food packaging to plastic bottles to commercial food, and they can affect the normal signaling of hormones. As Dr. Deidre Mattiske, a researcher at the School of BioSciences at the University of Melbourne, told ABC News, “It’s really important that we understand the impacts of EDCs, and that we’re trying to figure out ways to minimize exposure not only for males now but for future generations.”

With sperm counts dropping over the past several decades, the fertility rate has dropped 50 percent worldwide between 1960 and 2015, according to the New York Post. The article goes on to say that men today have less sperm and less testosterone than their fathers and that the total U.S. birth rate is 16 percent below where it should be to replace itself. With environmental factors and lifestyle choices taking their toll on fertility, there really need to be more avenues available for men to discuss this ever-increasing commonality. 

Few Support Systems for Infertile Males

Sadly, even with the growing number of men who suffer from infertility, there continues to be a lack of resources for men to openly discuss their feelings. Esmee Hanna, a male infertility researcher at De Monfort University in England, told Time that in a study of 41 males, 93 percent said that they suffered from depression, loneliness, and anxiety over a life without children, and some men reported being suicidal. Yet, nearly half of these men failed to seek help.

Why? The stigma continues that if a man cannot procreate, he is not a man. Liberty Barnes, a medical socialist, also states in Time, “So much of masculinity in America is about being strong, independent and capable as a man. If you can’t get your wife pregnant, you can’t help but compare yourself to other men and feel inferior.”

As assisted reproductive technology has evolved and become more accessible and socially acceptable to more people, the taboos and stigmatization of infertility have begun to give way to open discussion. Today, celebrities and personal acquaintances alike are more likely to share their joyful stories of becoming parents via assisted reproductions, to broad public and personal support. But, while approximately a third of infertility is related to female reproductive factors, a third to male reproductive factors and a third to combined or unknown factors, many of the support networks that have sprung up have focused on women.

As we reported back in 2013, a large percentage of male infertility can be corrected with treatment or lifestyle changes. But if men are too ashamed of the potential stigma to get tested, they have no way of knowing the cause of their infertility and if it is treatable. Even in cases in which male infertility is not treatable, more support groups and forums where men to discuss their feelings freely would go a long way toward removing stigma and normalizing the condition.