We like to think of ourselves as enlightened, capable of intelligent discussion and rational thinking. Few things will put those admirable qualities to the test 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 are 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 their own 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. Sure, we still see women gathering the brochures and educational literature in the waiting rooms and handing them to their husbands. But attend any infertility support group or conference, and there are more men showing up than ever before. The fact is, men aren’t as inhibited about admitting that they want to be dads and in significant numbers, they’re willing to do a lot to achieve fatherhood.
They’re 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. Couple that with the general tendency for men to brush off even routine health issues and infertility becomes hard to get at. Men simply don’t take care of themselves the way women do.
And that’s a big problem. They don’t even show up for physicals. So, although it is conventional wisdom 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 at many of the best IVF Centers, they are now taking special care to make sure that men are included in the treatment plan, with individual assessment and sensitively.
Infertility still packs the wallop of social stigma. Maybe it’s not as stinging as it was two or three 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. Some men confuse virility with fertility. Because my background is in fertility education, one of the main issues I see in men is their willing to compromise health if there’s a chance something – like prostate cancer treatment – may compromise the ability to perform. 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 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. As hard as it is – what with sperm sample production, sex-on-demand and the pressures of IVF – try to remember that sex is more than a way to make babies. It is relationship enhancing, it is stress relieving and it’s fun. Perhaps because there are now more treatment options that hold the possibility of overcoming infertility, men are demonstrating a willingness to tackle a problem that usually defies the easy fix.
Let’s hear it for the men!