Infertility is an issue that can deeply affect an individual and their relationship. Advice is most often focused toward women, so in this Spotlight feature, we focus on infertility in men and provide some science-based tips for dealing with it.
When the word "infertility" rears its worrisome head, most people first think about female infertility.
However, males are responsible for 20–30 percent of cases of infertility and "contribute to 50 percent of cases overall."
Men and women tend to respond to the experience of infertility differently: historically, women have thought that men deal with the issue easier, but in reality, men are simply less likely to open up about their emotions.
Finding out that you are infertile can be a devastating experience. A man might feel less male and as if they have failed. Some men believe that their masculinity is wrapped up in their ability to give their partner a child, and so feeling that they have lost that ability can produce strong negative emotions.
What causes male infertility?
Firstly, it is worth defining infertility. The World Health Organization (WHO) define it as "the inability of a sexually active, non-contracepting couple to achieve pregnancy in 1 year."
In the majority of cases, male infertility is due to abnormal sperm. Sometimes there are low numbers of sperm, while sometimes there are none at all. Or, the sperm may not be great swimmers or be deformed in some way.
These issues can be caused in a number of ways, including:
- testicular infection
- testicular surgery
- varicocele, or varicose veins in the scrotum
- hypogonadism, or testosterone deficiency
- cystic fibrosis
- some medications, including anabolic steroids
The list goes on. But often, there is no well-defined reason for the defective sperm. And in many cases, despite healthy sperm and no obvious issues with the partner's reproductive health, conception remains difficult to achieve.
Crack a window and let some hope in
In some cases, it is impossible for a man to impregnate a woman, but this is relatively uncommon. In most situations, there is still a chance. If you have been trying for a particularly long time, it might feel as though there is no hope — but, generally, there is.
If you haven't been to see an infertility specialist yet, you should consider it. They can pin down where the problem might lie and give general tips and advice. Talking with an expert also helps you to realize that you are not alone.
Also, there are options. For instance, many couples now conceive through in vitro fertilization (IVF). In fact, in the past 30 years, 1 million IVF babies have been born in the United States. It is vital to remember that there are other roads to be taken as you go through this troubling time.
The remainder of this article offers tips to deal with the emotional and practical side of infertility.
1. Get the facts
First and foremost, find out what's going on. If you just think that you are infertile, or making a baby hasn't happened despite a year or so of trying, it's time to get checked. There is no point beginning a journey into sorrow without knowing if it's even justified.
Go to an expert, and get your sperm tested. Ask questions. Read as much as you can. Understand what your particular issue is, and what that means for your chances of conception.
2. Make plans
One of the toughest parts of dealing with male infertility is not knowing how long it will last. Making plans where possible can help you to feel that you are still in charge.
Set targets and limits. With your partner, discuss what procedures you are prepared to go for, and what emotional and financial levels you can both handle. Pregnancy is often the result of repeated efforts, whether through natural intercourse or fertility treatment. It will help no one if you both end up as financially ruined, dessicated emotional husks.
Consider all options. Talk through all the options — adoption, IVF, or donor sperm. Understanding and talking about potential avenues will help should you face any setbacks further down the road — and if one thing doesn't work, you'll know what you're trying next.
3. Take control
There are some scientifically proven ways to improve sperm quality. Often, the simple act of taking back some control can go a long way to help deal with infertility; it fights off that creeping sense of helplessness.
The following list is by no means exhaustive but provides some simple (and scientifically supported) measures that can be taken to give your sperm the best chance of meeting and greeting an egg.
Eat right. In short, lay off meat products and stock up on veg. Understanding the exact impacts of overall food intake is difficult, but a diet including lean meats, vegetables, legumes, and grains seems to improve sperm motility.
Maintain the right weight. There are fairly strong links between being overweight and male infertility.
Reduce stress. No, I'm not kidding, even though it sounds like a joke. Infertility is stressing you out, which, in turn, might be making infertility worse. And sadly, the evidence says that it's probably true. The section on coping strategies below offers some advice on minimizing the impact of stress...and breathe.
Get active. Although the link between physical fitness and sperm quality has not been definitively proven, being physically active will prevent obesity, which is certainly linked. Exercise also helps to relieve stress, so it's worth getting sweaty. According to one study, bicycling for just 5 hours per week could do the trick.
It's worth noting that there are a host of companies that offer "magic" pills and supplements to turn your sperm into tiny athletes, but, as I'm sure you are already aware, evidence for these types of products is lacking.
There are also some behaviors to avoid in order to improve sperm health:
- smoking, as it lowers sperm count and increases the risk of misshapen sperm
- alcohol, as it reduces testosterone production — it is therefore sensible to moderate drinking
- don't use lubricants during sex, as some may hinder sperm
- keep your balls cool, as hot testicles, according to some studies, may be less efficient at producing sperm — so avoid hot tubs, tight underwear, and saunas
4. Talk about it
According to traditional stereotypes, men don't like to talk about their problems. Although this stereotype does often hold true, it is not the case for everyone. As clichéd and trite as it might sound, "a problem shared is a problem halved."
Keep communication channels open. You don't have to broadcast it far and wide, but speak with someone: a doctor, a nurse, a friend, a counselor, a support group — anyone. It will ease your burden, and they might offer a new perspective.
If any of the following signs crop up regularly, it is important to talk with a doctor or counselor who is trained in infertility:
- abusing drugs or alcohol
- thoughts about harming yourself or others
- becoming angry or abusive easily
- losing interest in things that you once enjoyed
- insomnia or sleeping much longer than usual
5. Develop healthy coping strategies
It's easy to let stress build up until you crack. Some people handle it better than others, but everyone can let it get the better of them sometimes.
It is therefore important to find ways to loosen the stopcock every once in a while. The following coping strategies may help to keep your mind on the straight and narrow.
Keep moving. It doesn't matter what you do — be it weight lifting, running, swimming, or basketball — whatever it is, get sweaty a couple of times each week. Exercise has repeatedly been shown to help reduce stress. Moving about costs nothing, so take advantage.
Relax. Men, in general, are less likely to get a massage than women, but times are changing. Even if a massage isn't something that you'd normally consider, it is a really good way to de-stress. Meditation and yoga are other good options.
For instance, a huge meta-analysis published in JAMA in 2014 concluded that:
Sure, "moderate" doesn't sound amazing, but in the context of a JAMA review, it means that a genuine, statistically significant effect was measured. So, if added alongside other coping mechanisms, it could really help.
Write. Not everyone is a natural author, and most people haven't tried writing anything substantial since they were at school. However, no one is telling you that it needs to be published anywhere. The simple act of writing out your thoughts can help you to work through how you are feeling, and to start the process of dealing with it.
Whether you choose to write it and immediately set fire to it or keep it stored away for a future you to discover makes no difference. It is the act of writing itself that is important.
And this isn't just another one of those wishy-washy interventions; "writing therapy" is a real thing. Otherwise known as written disclosure therapy, it is not used particularly widely, but there is some evidence to suggest that it can have positive effects on psychological well-being and even reduce blood pressure.
Cry. Again, the male stereotype dictates that we should never shed a tear — at least not when anyone is looking. But nowadays, plenty of men are prepared to cry every now and again. And, if you are in private and you know that you will not be disturbed, open the floodgates. It's a genuine cathartic release.
Dr. Judith Orloff, who is a psychiatrist at the University of California, Los Angeles with 20 years of clinical experience, writes, "Typically, after crying, our breathing and heart rate decrease, and we enter into a calmer biological and emotional state."
Laugh. You can't force it, and it may feel like the last thing on earth that you want to do — but it can help. It counts as exercise and stress relief at the same time. Put on a movie that you know will tickle you, or hang out with your friends for a bit. Don't hide away in a darkened corner.
The last word
Infertility affects people in a range of different ways — both physically and emotionally. However you are dealing with it, it is important to remember that you are not alone and that there is help available. Keep active, talk, and treat your mind and body well.