Jun 30th 2020

Challenge: Educating Men About Fertility

People often turn to reproductive specialists to help them build a family when they can't get (or stay) pregnant on their own. And for many of them, it's worth the time and expense. According to data from the Society for Assisted Reproductive Technologies (SART), 71,769 babies in 2017 and 74,590 babies in 2018 were born in the US with the help of assisted reproductive technology. 

But there are many more couples out there who want to get pregnant but are having trouble—and not always because of female fertility.

What men know about fertility…and what they don't

 

Many men are undereducated about male and female fertility issues according to a presentation at the American Society for Reproductive Medicine (ASRM) convention and expo in October 2019. This presentation discussed how a Texas research team conducted a survey of men between the ages of 18 to 50 and found that only 6 percent knew that the man could contribute to a couple's fertility. Not only that, but the men surveyed also underestimated the decline of age-related fertility in women and overestimated the chances of success of in vitro fertilization (IVF) in women as they aged.  

But there's another complicating factor: Some men don't have a primary care physician, let alone a urologist or reproductive medicine specialist. That's problematic for infertile men in particular because they are more likely to also have other health conditions that need addressing. A 2018 study in the journal Fertility and Sterility found that infertile men were more likely than fertile men to have hypertension, hyperlipidemia (when blood cholesterol levels get too high), and hyperuricemia (a condition involving elevated uric acid levels in the blood that can lead to conditions like gout or chronic kidney disease). 

If infertile men don't have a primary care provider, those chronic health conditions may go undiagnosed or untreated which can jeopardize their overall health and life expectancy. Those untreated conditions may also play a role in their potential ability to procreate. 

With this in mind, one aspect of caring for female patients trying to get pregnant from a male partner can be to discuss whether the man has a primary care physician—and, if not, suggesting he seeks one out. 

Primary care physicians who see men with health issues like high blood pressure may also want to discuss the potential link between certain health conditions and fertility, and refer them to a reproductive medicine specialist where needed.

What's on the horizon?

 

If awareness about male fertility is lacking among men, there's also a lack of research into male fertility causes and treatments.  Experts hope that increasing research on male fertility will continue to lead to more successful treatments for men who are struggling with the issue.

In the meantime, physicians and providers can look for opportunities to have conversations with their patients about their fertility challenges and refer men to an urologist for an initial evaluation. A visit to the urologist may start with a physical exam and include blood work to rule out other precipitating factors. The urologist may also recommend other types of tests such as a semen analysis and hormone testing.