Written by Sam Rider
Around the world, male factor infertility is on the rise.
Sam Rider explores its impact on men’s mental health, investigates DIY fertility tests and learns how stigma is being dismantled by an unlikely group.
Fertility issues are more common than you might think – and they’re on the rise.
In the UK, one in six couples will have trouble conceiving. 40% of the time, it’s due to male factor infertility. 15-30% is “unexplained infertility”, where there’s no obvious cause.
Every year, these numbers are rising.
The strain on the NHS due to Covid is making matters worse. The pandemic has negatively impacted the fertility treatment for 92% of patients, with 82% of tests or treatments postponed.
“The psychological impact of infertility can take a huge toll on a couple’s mental health,” says Francesca Steyn, Peppy’s Director of Fertility Services and a fertility nurse for more than 15 years.
“For men in particular, it can lead to feelings of failure and guilt. That’s why it’s so important people have access to counselling and support every step of the journey.”
Infertility can be more stressful – and expensive – than divorce.
Fertility challenges are distressing – emotionally, physically and financially. 90% of people who go through it will experience some level of depression, and 42% will report feeling suicidal.
In a recent survey 61% of people rated infertility as more stressful than divorce. Treatment costs can be equal to a deposit on a house (the average was £11,378).
“It’s an emotional rollercoaster,” says Francesca, “and most go into it completely unprepared. At school, they hammer into you how not to get pregnant, but there’s no education around what happens if you can’t.
“Once you start IVF there are obstacles every step of the way. Anxiety is through the roof. Even if the first few results are positive, and you get pregnant, waiting for the next scan can feel like an eternity.”
Male fertility goes mainstream.
As popular culture and health tech companies continue to raise awareness, fewer and fewer men are having to go through infertility alone.
Last month, the BBC aired Me, My Brother and Our Balls, “an intimate look into male fertility”, with Chris Hughes of Love Island fame. And last year, documentary The Easy Bit examined fertility treatment from the male perspective, something that Francesca says is often an afterthought.
Since 2003, Movember has driven men’s health issues up the national agenda. And tech companies are increasingly addressing historically taboo subjects, from low libido to low sperm count.
“The stigma around mental health and male infertility is certainly changing but more needs to be done, especially in the workplace,” says Francesca.
“Your fertility status does not define your masculinity.”
Too often, men are reluctant to speak up about fertility issues but, Francesca says, the LGBT community is pushing hard to change this.
“Gay men seem to talk about their fertility more openly,” agrees Michael Johnson-Ellis, co-founder of Two Dads UK, who’ve been supporting people going through surrogacy since 2004. “Most of us will need to use reproductive science, so there isn’t that stigma with IVF as there often is with heterosexual men.”
Two Dads UK are campaigning for smarter guidance for healthcare professionals in surrogacy and challenging NHS trusts to be more inclusive. “We also want to encourage more men to talk openly about their fertility status and, importantly, how to improve it if this is an option,” he adds.
“Your fertility status does not define your masculinity. Regardless of the results, it’s important for us as a community to support each other.”
Kick off your fertility MOT.
While Francesca notes a word of caution when using these services – as a negative result without adequate support could trigger anxiety that’s “ten times worse” than finding out from your GP – she thinks undertaking a fertility MOT is something all young men should be doing.
“People should be more educated about their fertility and encouraged to look into things earlier,” she says, highlighting how having mumps as a child can be a common cause of infertility in men, as can varicoceles (enlarged veins in the testicles).
Infertility can be reversible; “just don’t suffer in silence,” says Francesca. “Reach out to the counsellor at your clinic. Make sure you understand your options. Be open and honest with your family and friends.
“And, above all, talk to your partner, listen to each other, and make sure you spend time together doing things that aren’t fertility related too.”
Men need better mental health support.
It’s why we offer the Peppy Fertility programme, for men and women, providing group and one-to-one chat with expert fertility practitioners, specialist fertility mental health support and free access to vetted resources.
In the workplace alone, we’ve found that the right guidance and advice can reduce absenteeism due to fertility treatment and halve attrition rates.
The potential to break down the stigma around male fertility in the wider society is huge. “Infertility is a loss and a grieving process,” adds Francesca. “Men tend to take all of that emotional turmoil on themselves, often dealing with the emotional strain of two people.
“But with the right evidence-based advice, resources and signposting, we can help you cope with the highs and lows of fertility treatment, wherever that journey takes you.”
This Fertility Awareness Week (2nd-5th November), we’re running a free online event, Fertility in the Workplace, on Thursday 5th November. Sign up to join the event here.