THE MALE INFERTILITY INJUSTICE

More than HALF the problems of infertile couples now lie with the man — and sperm counts have fallen by 60%. So why IS the IVF industry still focused almost wholly on women?

MALE fertility in the West is in rapid decline. Data from the Human Fertilisation and Embryology Authority, which regulates infertility treatment in the UK, shows the number of infertile men being treated has doubled in just four years.

The biggest ever study of male fertility in the developed world revealed a 59.3 per cent reduction in average sperm count between 1973 and 2011.

‘We have a huge public health problem that, until now, was under the radar. Health authorities should be concerned,’ says Dr Hagai levine, an expert in environmental health at the Hebrew University in Jerusalem, who led the study of declining male fertility which was published in the journal Human Reproduction Update. He says his findings should be treated as the ‘canary in the coalmine’, providing a warning for the future of male reproductive health.

Poor lifestyle is a recognised factor, as Dr Channa Jayasena, a specialist in diabetes and hormone activity at Hammersmith Hospital in london, explains: ‘Rising obesity and diabetes levels are major factors in increasing rates of male infertility. This is because they damage overall fitness.

‘But, inexplicably, many affected men are apparently fit and healthy. Heavily processed foods, environmental pollution and lack of exercise may also be contributors to the problem.’

Other researchers have suggested female hormones in the water supply — from the contraceptive pill — could also be a factor.

last year, the World Health Organisation warned that understanding of male infertility was ‘very low’ and the UK’s Medical Research Council (MRC) issued a call for research proposals.

Whatever the cause, it’s now acknowledged that in more than half of cases, the problems faced by infertile couples originate with the man.

And yet, the infertility industry — which is led by gynaecologists focusing on female reproduction — continues largely to ignore them.

Good Health spoke to a man who told us he and his wife spent £20,000 on failed IVF, only to later be told by the clinic that the problem lay not with his wife, but with his sperm quality.

‘There is a lack of recognition that male factor infertility is a problem — and because of this, a lot of IVF is unnecessary,’ Dr Ashok Agarwal, a leading infertility specialist from the Cleveland Clinic in Ohio, told Good Health.

Jonathan Ramsay, a urologist and male fertility expert at Imperial College london, concurs: ‘It is well known that men are just as likely as women to be the cause of a couple’s inability to conceive.

‘But infertility specialists are invariably gynaecologists who specialise in women’s reproductive health and don’t have a detailed understanding of how to pick up defects in sperm production. There are relatively few of us working in this area.’

Yet instead of a full health check and physical examination of their reproductive system, men are often asked simply to give a sperm sample, which is then given only basic assessments to check for the number and movement (i.e. motility) of sperm — and not, say, investigating why the sperm might be poor quality.

AS THE Mail reported yesterday, the failure to diagnose or treat infertile men leads to the ‘absurd’ situation where women routinely have IVF when there is nothing wrong with their own fertility, according to Sheena lewis, a professor of reproductive medicine at Queen’s University in Belfast and chair of the British Andrology Society.

‘ We are giving an invasive procedure to a person who doesn’t need it in order to treat another person,’ she said.

‘That doesn’t happen in any other branch of medicine.’

Professor lewis is campaigning for the use of sperm DNA testing and has published numerous studies showing that poor sperm will not work in assisted fertility treatment.

‘I think the IVF industry is out of control — it wrecks marriages, leaves people very unhappy and mostly doesn’t work,’ adds Dr Sheryl Homa, formerly one of the world’s pioneering embryologists.

She is now the scientific director at the private Andrology Solutions clinic in london, the only infertility centre in Britain focusing on men. ‘IVF is much worse than cosmetic surgery,’ she adds.

‘If, like IVF, your facelift or breast augmentation carried a maximum 30 per cent chance of working, you wouldn’t do it.’

The experts’ concerns are borne out by the experience of Dan James, 32, a professional cellist from Dartford in Kent, and his wife Gemma, 35, also a cellist. They tried for a baby for two years before seeking help in April 2015.

The couple, who have been together for ten years, were referred for NHS infertility treatment.

Although he was quickly told the results of his sperm samples (which he had to do at home) showed he had very poor motility, meaning he would not be able to naturally father a child, ‘all the focus was on Gemma’, says Dan.

‘We went back to the GP but we were told I should just take multivitamins. He said that before we would be referred for IVF, my wife would still have to undergo at least six months of investigations even though I was the one with the identified fertility problem and she had already had initial tests that showed she was OK.

‘They were going to put dye into her fallopian tubes to check they weren’t blocked, insert a balloon to check the uterus was alright and make her take Clomid, a drug which makes women produce huge numbers of eggs, which in itself is unnatural.

‘ Doctors have a tick- box mentality that they have to focus on women,’ he adds.

Yet when it comes to male fertility, a low-tech approach may actually be much more useful and vastly less stressful for couples. There is increasing interest in boosting sperm quality in subfertile men by giving them antioxidant dietary supplements.

The theory is that low antioxidant levels mean sperm DNA may be damaged, affecting swimming capability and the ability of the sperm to break through and fertilise an egg.

This summer, the European Society of Human Reproduction and Embryology conference in Barcelona gave unprecedented space to the discussion of successful results from studies by Dr Agarwal and others, investigating dietary supplements and other treatments for sperm problems.

Dr Agarwal, a world authority on identifying methods of repairing and boosting sperm quality, has already produced a number of studies indicating benefits from antioxidant supplements such as lycopene (see box, below).

Dr Albert Salas-Huetos, of the Universitat Rovira i Virgil in Reus,