In honor of Men’s Health Week (June 9-15), Progyny hosted an important conversation about male reproductive health. While 1/3 of infertility cases are caused by male-factor or sperm-related infertility, too often men are left out of discussions about fertility and family building, creating challenges for individuals and couples both physically and emotionally. For men and those who are in relationships with men, it’s important to unpack the stigma surrounding men’s reproductive health to remove barriers to care and ensure both partners play an active role in the fertility and family building process.
This webinar featured:
- Joe Liverani: National Account Manager, Progyny
- Joshua Halpern, MD, MS: Reproductive Urologist and Chief Scientific Officer, Posterity Health
- Justin Smith: VP of Client Success, Progyny
- Monica Ochoa, LCSW: Mental Health Therapist, Pinnacle Fertility
The stigma around male infertility
Male infertility accounts for 1/3 of infertility cases, but don’t be surprised if you didn’t know that as it’s so infrequently discussed. Conversations about infertility in media usually focus on women and those with ovaries, and rarely do you see male celebrities or prominent figures opening up about their struggles with infertility.
Unfortunately, there’s a stigma when it comes to male infertility that contributes to this culture of silence. In many cultures, masculinity is linked to virility, and this can make men who are struggling with fertility issues feel like they’re not living up to deeply rooted and held social norms about what it means to “be a man.” Infertility can be seen as a personal failure even though it has absolutely nothing to do with how masculine or manly you are.
Even though these beliefs aren’t rooted in truth, they still have very real consequences for those experiencing it and their relationships. It can lead men to put off getting tested or screened because they aren’t willing to accept that they could be part of why they’re having trouble conceiving with their partners. But it’s important to recognize that infertility isn’t anyone’s “fault” – you and your partner are on this journey together, and a huge part of that is being equally involved in getting to the root of the problem and working together to solve it.
Navigating male-factor infertility
Whether you’re ready to start your family building journey or just want to get an accurate sense of your options and assess your fertility, getting tested earlier rather than later is better, since it will help your reproductive endocrinologist (REI) and reproductive urologist (RU) pursue the most effective treatment options.
If your partner is a woman, getting tested early can also be extremely beneficial for the health of your relationship, especially because it’s still common for women to carry most of the physical and emotional burden of fertility treatments. When you choose to get tested early, it’s a way to show your partner that you’re in this together. Not only will you be able to catch any potential issues with your fertility earlier and arm you with more information, but it can also help to prevent resentment and foster a shared sense of responsibility.
During your initial assessment, your reproductive urologist (RU), a urologist who specializes in male fertility issues, will be aiming to get a holistic picture of all the different factors that may impact your fertility. You can expect them to ask you questions about your medical and sexual history, as well as your lifestyle and your reproductive history (e.g., whether you’ve had children before). They will also conduct a physical exam to check the health of your testicles and screen for any potential concerns.
Next comes diagnostic testing. Typically, this means starting with a semen test. This provides your RU with a snapshot of the condition of your sperm. This is also an easy way to catch certain conditions like azoospermia (when there is no sperm in your semen), which impacts 1-2% of all men and represents 10% of men with infertility. Depending on their initial evaluation, they may also recommend additional tests such as blood work, hormone testing, and genetic testing.
Going into this initial consultation, it’s normal to feel nervous and vulnerable. That’s okay! It doesn’t mean there’s anything wrong with you – it just means you’re human. If you have a partner, share how you’re feeling with them and allow them to support you. Remember that you’re in this together, and you’re working towards a shared goal: gaining clarity and getting answers so you’re best equipped to move forward in your family building journey.
Treatment options for male infertility
There are many possible treatments for infertility depending on your unique situation. It is important to discuss your options with your doctor. One large differentiator between men and women, is men can have some control over sperm quality as it regenerates every 3 months. While there is a possibility of improving sperm quality, there are some situations that do not change, which will lead to other treatments/interventions.
- Lifestyle changes: Marijuana and smoking cessation and reducing alcohol intake is highly recommended, especially if you are habitually consuming any of these substances. Your doctor may also recommend implementing regular exercise and losing weight if they feel obesity may be negatively impacting your fertility. Regular exposure to high heat – hot tubs, saunas, steam rooms – is also something to avoid.
- Medication: Your RU may prescribe certain medications that are geared towards improving your fertility (e.g., improving levels of testosterone and other hormones that promote sperm production) or sexual function.
- Surgery: Surgical intervention may be required in instances where lifestyle changes and medication aren’t enough. This can encompass a lot of different things that range in invasiveness, so it’s best to listen to what your RU and reproductive endocrinologist recommend for you and your partner.
Common myths and how to move forward
There are a lot of misconceptions out there about male infertility. Here are some of the top ones:
Myth #1: Infertility only affects women.
When faced with trouble conceiving, it’s common for a lot of men to think, “It couldn’t be me.” But that couldn’t be further from the truth, since anywhere from 1/3 of all infertility cases are due to male-factor infertility. Infertility is not a women’s only issue – it’s a couple’s issue, and it’s important that both partners take the necessary steps to address any challenges faced.
Myth #2: Men can take testosterone to promote fertility.
Ads for testosterone replacements are seemingly everywhere, so you wouldn’t be at fault for thinking they might help promote your fertility. After all, testosterone is an essential hormone when it comes to men’s health, affecting everything from vitality, sex drive, muscle mass, and – of course – fertility. Unfortunately, the testosterone you need for sperm production has to come from inside your body in order to be helpful for your fertility. In fact, taking testosterone exogenously, whether through injection or topical gel – can actually harm your fertility because it shuts down your body’s own production of testosterone and sperm. This isn’t to say that you can’t take anything to help with your testosterone production, but that’s why it’s crucial that you work with a reproductive urologist, who has medical expertise and is qualified to help.
Myth #3: Experiencing infertility means I’m not a “real man.”
A lot of men are conditioned to believe that male infertility equals a lack of masculinity, which can create a lot of shame and avoidance. You might feel like something’s wrong with you, and it can be really isolating especially if you don’t know how common male infertility actually is. Not only can it be damaging for your own well-being, it can also harm your relationship. That’s why it’s so important to shift the conversation and reframe infertility as a shared medical journey instead of personal inadequacy. Dealing with infertility doesn’t mean you can’t have a fertility journey filled with hope and dignity. While you are going through the journey, its important to find support that can help you through. This support can come from an employee resource group through your company, community support groups that can be found through your clinic/RU, and of course any family and/or friends you feel comfortable sharing with.
These misconceptions about male infertility won’t be reversed overnight. But that’s why it’s so important that we continue to normalize conversations such as this about how common and normal it is. It means educating people in schools, in the workplace, in media, and in healthcare as well – about how male factor infertility is very common and often treatable. And most importantly, it means helping men feel seen and supported, physically and emotionally.
If you’re a Progyny member or have access to the Progyny benefit, your benefit includes access to Reproductive Urology services, as well as mental health support and guidance from a dedicated Progyny Care Advocate (PCA). In addition to helping navigate care and treatment options, your PCA can be another part of your support system as you tackle the challenges that can come up as you navigate your fertility journey.
If you are a Progyny member and have any questions about your benefit or coverage, please call 888.597.5065.