It’s unbelievable how often women approach me with stories about enduring years of infertility – undergoing diagnostic procedures, taking medication, charting basal body temperature, checking cervical mucus, investing in digital fertility monitors, eating all-organic superfoods and petitioning the fertility gods – only to discover their inability to conceive was their partners’ poor sperm count.
We often think of reproduction as women’s work. And rightly so! As a mother of four, I can tell you it was not my husband who suffered the nausea and aches of pregnancy, the labour contractions, or the soreness of breastfeeding. Womendeserve serious credit for the back-breaking work of human reproduction.
Nonetheless, men still play a fairly crucial role in conception.
As I discovered during the research for my book, Conceiving Masculinity: Male Infertility, Medicine, and Identity, men are rendered invisible in our collective imagination when it comes to reproduction. When a woman can’t get pregnant, she assumes something is wrong with her. How could she not when so many books and websites about conceiving are geared toward women?
As other scholars have pointed out, when a woman gets pregnant, the man gets credit. When a woman can’t get pregnant, it’s her fault. We live in a culture dedicated to celebrating male virility and protecting masculinity.
Cultural assumptions about women’s reproductive responsibilities have shaped medical science and the medical system. Although male infertility is as common as female infertility, we live in a world where there are more practitioners and technologies focused on treating women than assessing and treating men.
According to the World Health Organization, the proper assessment and diagnosis of male fertility should include a semen analysis and a thorough physical examination. In the golden age of IVF, doctors can easily skip the physical exam. The purpose of IVF is not to discover and treat the specific cause of a couple’s infertility, but to circumvent it. In my research, this proved to be very frustrating for men who sought help to improve their fertility.
For cases of male infertility, embryologists may hand select a single sperm and shoot it into an egg, a procedure known as intracytoplasmic sperm injection or ICSI (pronounced “icksy”). Laboratories around the world are reporting using ICSI in 50-70% of IVF cycles. Recently, an embryologist from Cyprus told me he uses ICSI in 100% of the IVF treatments at his clinic.
The ethics and perceived complications of IVF-ICSI are debatable and a topic for another day. Relevant to this discussion is what these statistics suggest – that there are a lot of infertile men out there who may not even know they are infertile. There may be other treatment options available to improve these men’s fertility status, but they are never told about them.
Instead, women shoulder the brunt of treatments, believing they are responsible for couples’ childlessness. Compounding the physical demands of IVF, women alone often bear the stigma and guilt associated with infertility.