Saturday 18 November 2017

Why it's time men opened up about infertility

Women will share their problems in conceiving, but men remain reluctant to discuss it, writes Chrissie Russell

Statistically it's as likely that the problem could be on the male side

The internet is rife with talk of infertility. "Hi, I'm Aisling and I'm infertile," writes one woman in an online forum. "I've got mild polycystic ovary syndrome and have been TTC for 2.5 years ... It's been a rough journey but we're still on the path and hoping."

So frequent is the topic's discussion that 'trying to conceive' is reduced to the more quickly typed 'TTC' and over the forum's 100 or so pages, Aisling's post is met with shared stories of trouble, tips on treatment and inspirational tales of couples who successfully procreated in the direst of circumstances.

But as you wade through the fertility chat rooms, it becomes apparent that the voices sharing are predominantly female. Fertility, it seems, is a woman's problem.

Except, of course, that it's not. Around one in six couples in Ireland face infertility problems. And in up to half those cases the problem is on the male side.

"In terms of my clients, about 40pc of problems are contributed by a male factor," says reproductive health expert Declan Keane, director of Dublin fertility clinic ReproMed.

"There's a tendency to focus on the female but statistically it's as likely that the problem could be on the male side."

Problems vary from low or non-existent sperm counts, DNA fragmentation -- where quality of the information in the sperm cell is poor -- to problems with sperm production or an abnormality on the male chromosome.

Depending on the problem, treatments range from simple changes in diet and lifestyle, designed to boost sperm counts and quality, to a raft of clinical procedures.

The most popular male fertility treatment is ICSI (intracytoplasmic sperm injection) whereby a single sperm is directed into an egg should the problem lie with a low count or poor mobility.

The treatment costs around the same as IVF, around €5,000 for a six-week cycle, has been used in Ireland since 1994 and has a high success rate but hasn't IVF's high profile simply because male fertility is rarely talked about.

"In a lot of IVF clinics, 60pc of the work is probably ICSI but they call themselves IVF because people are more used to hearing that and know what it is," says Dr David Walsh, medical director of Dublin's Sims Fertility Clinic.

He explains: "Women are collegiate in fertility issues; they'll discuss problems and treatments. Men are isolated. Women will talk about IVF but not many guys will go down the pub and ask his friends 'have you tried ICSI?'"

But unfortunately male reluctance to discuss the problem could prolong the agony of trying to conceive.

Ian Claxton is the founder of Galway's Natural Fertility Clinic and specialises in using complementary therapies such as acupuncture, traditional Chinese medicine and nutrition, alongside conventional medicine, to aid couples trying to conceive.

He says: "I get plenty of couples coming in thinking they'll have to spend thousands on IVF when all they need to do is get the guy to change some small things in his lifestyle.

"Diet, environment, stress, too much dairy, wearing briefs instead of boxers -- these are all things that can affect sperm production.

Men's reticence over the issue also has a biological, not just cultural, factor. Women produce just one egg a month and have a finite supply, making them much more emotionally invested in the reproductive cycle than men, for whom sperm is in constant production.

"Men release 49 million sperm during ejaculation while women have just one egg," says Dr Walsh. "It's not surprising they often display a greater level of control and interest in the process."

But just because the female biological clock ticks more loudly doesn't mean that men don't also have to worry about the effects of ageing on their fertility. Once they pass the age of 48, men's genetic quality of sperm deteriorates, making the odds of successful conception less likely.

Moreover, research suggests male infertility is on the rise. Ian Claxton adds: "It's really important more guys become aware of their own fertility and the factors affecting it. Unless men start opening up and talking more, it's a problem that's harder to fix."

Irish Independent

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