We like to think of ourselves as enlightened, capable of intelligent discussion and rational action. Few things put those admirable qualities to the test as fast as male infertility. Mention male factor at a party and reflexively, most men blanch, squeeze their knees together and change the subject, even if they’re not affected. Not that things haven’t improved over the years. They have. The atmosphere has palpably relaxed. The famous and not-so-famous talk about their personal trials with and triumphs over infertility. True, it’s still mostly women doing the talking. But their candor, coupled with the streaming reports about medical and scientific advances, has made it easier for men to acknowledge procreative problems, either theirs or as part of an infertile couple.
The proof? There are more men in waiting rooms supporting their spouses through treatments; they are more proactive in seeking information about male factor and pursuing therapies. The fact is, men aren’t as inhibited about admitting that they want to be dads and they are willing to do a lot to achieve fatherhood. They are getting better about separating male infertility from their machismo.
It’s important that we do everything we can to encourage that trend. For far too many years, the male perspective on infertility wasn’t even a blip on the radar screen of reproductive professionals and patient advocates. Once upon a time, nobody thought that infertility was part of the male agenda. It was a commonly held belief that anything to do with the disease had to begin with the woman.
That history has its own inertia. And believe me, men have a point of view on the disease. But there’s a push-pull between the need for privacy and the need for disclosure and support. The fact is, men don’t like to talk about it. When men go out for lunch, they are more likely to talk about the woman at the next table. No matter what’s wrong with them, they don’t do well man-on-man.
Couple that with the general tendency for men to brush off even routine health issues and infertility becomes hard to broach. Men simply don’t take care of themselves the way women do. And that’s a big problem. They often don’t even show up for physicals. So, although it is well settled that infertility is a couple’s problem and that male factor is the root cause almost half the time, men are often last to be analyzed and diagnosed. That’s why getting the man into a doctor’s office to get a semen analysis is so important. And it’s not just about making babies; a low sperm count can also be a symptom of deeper underlying medical issues, from testicular cancer to environmental toxins or even male menopause (often called Andropause).
It is also true that infertility still packs the wallop of social stigma. Maybe it’s not as stinging as it was two decades ago. Yet the bias is stubborn, hanging on in ways both insidious and blunt.
We see and feel it in the off-hand comments of friends and in the sitcom kitsch of family hour TV. It’s there in the political debates over insurance mandates to cover treatment and in pointed religious discourse.
In response, infertile women have responded by actively seeking solace in the support of peers and professionals. Infertile men, on the other hand, still tend to withdraw into lonely funks of self-doubt, crumbling self-esteem and suspicion about their manliness. Women tiptoe around their partners because they worry the men in their lives may be feeling guilty and mortified by their inability to impregnate. We still confuse virility with fertility. It’s hard for most men to grasp that sperm count has nothing to do with masculinity or sexual performance. The truth is, one thing has nothing to do with the other. To survive in a marriage you have to learn to separate baby-making sex from intimate sex and if you don’t, you’re doomed. Men are sometimes so “susceptible” to thinking that the inability to impregnate their partners compromises their sexuality, they begin to feel useless. That worry, if it continues long enough can lead to performance anxiety and loss of desire.
The good news is that more men are feeling more liberated and less humiliated and reticent. To some extent, the credit goes to, yes, Viagra. As Bob Dole said “if you have a problem, this is one we can do something about.” People are talking about erectile dysfunction and I think it’s spilling over into the fertility conversation. Perhaps because there’s something concrete for more men to do, there are treatment options that hold the possibility of overcoming infertility, men are demonstrating a willingness to tackle a problem that usually defies the easy fix.
When it comes to male infertility, it’s time to end all of the misconceptions and replace it with empathy, understanding and facts.
Author: Pamela Madsen, The Fertility Advocate, Guest Blogger
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