The Statistics
Most statistics on infertility focus on cisgender, heterosexual couples. According to the NIH (National Institute of Health in the US), “infertility is defined clinically in women and men who cannot achieve pregnancy after one year of having intercourse without using birth control, and in women who have two or more failed pregnancies.”
While more research needs to be done to include couples who are not cisgender and/or heterosexual and their struggles with infertility, the statistics we have on cishet couples highlight some of the experiences of male infertility on a clinical level.
- Approximately 7% of men are affected by infertility
- Among cishet couples struggling to conceive: 30% of the time it’s related to male-factor infertility, 30% of the time it’s related to female-factor infertility, 30% of the time it’s a combination of subfertility in both partners and approximately 10% of infertility cases are unexplained
- 10-15% of infertile men have a complete lack of sperm
- Approximately half of male infertility cases have no known cause
- Sperm count has declined by over 50% in the last 40 years
The Causes
According to the Mayo Clinic, known causes of male infertility include the following:
- Abnormal sperm production or function: This can be influenced by several things, like genetic defects, health problems, infections, undescended testicles, or enlarged veins
- Problems with the delivery of sperm: Due to sexual problems (like premature ejaculation), genetic diseases (like cystic fibrosis), or structural problems (like a blockage in the testicles)
- Overexposure to certain environmental factors: This can include chemicals, cigarette smoking, alcohol and drugs, medications, high blood pressure, depression, and exposure to heat
- Damage related to cancer or treatment: Like radiation or chemotherapy
The Mental Health Aspect
No matter the reason or severity of one’s experience with male infertility, the issue is real, painful, and human, and those going through it deserve good care and a chance to discuss it openly, without fear of judgment.
Sadly, that is not the typical experience.
In an article for The Guardian, Andrew Anthony talks to men and experts about the stigma attached to male infertility and the decline in fertility in recent history. “It’s like a judgment of your masculinity,” says one man, whose “failure” to have a child left him depressed. Another interviewee said he learned he had no sperm during a five-minute conversation with his GP, who didn’t offer any type of further care or discussion.
Despite infertility being common, men still face cultural stigma. In an interview for his practice (CARE Fertility), Dr. Kevin Doody says our society tends to associate a man’s fertility with his virility, despite this not being based in reality.
An NCBI study found that “men with male factor infertility experienced more ‘negative emotional responses’, including a sense of loss, stigma, and reduced self-esteem.”
This is tied to anthropological theories of masculinity and reproduction, and while these stereotyped ideas are deep-rooted, they need to be addressed and more attention needs to be paid to how male infertility impacts men, who are often taught to deny their vulnerability and need for emotional assistance.
The Treatments
According to the Mayo Clinic, diagnosing male infertility problems typically involves a physical examination, going through your medical history with a doctor, and having a semen analysis. Further tests may be recommended to identify the cause of infertility. These can include a scrotal ultrasound, a transrectal ultrasound, hormone testing, post-ejaculation urinalysis, genetic testing, testicular biopsy, and specialized sperm function test.
Although the cause of male infertility is often unknown, doctors may still advise seeking treatment, which can include surgery, treating infection, treating sexual intercourse problems with medication and/or counseling, hormone treatments, and assisted reproductive technology.
The Takeaway
Infertility can be emotionally exhausting, frustrating, and devastating for couples and individuals. Male infertility has its own unique stigmas and struggles attached. When one longs to conceive a child and that doesn’t happen, there are things to be done, but unfortunately some men are still unable to father a child biologically even after treatment. Whether they look for a different route to becoming a parent, or take another path, it’s important they have the information and emotional support from peers and medical professionals to make the decision that is right for them, free of shame.