The Guardian (USA)

There’s a crisis in male fertility. But you wouldn’t know it from the way many men behave

- Elle Hunt

Women are rarely given the chance to forget about our biological clocks: their starting, slowing, stopping. I remember talking about whether I’d want children with my mum when I was six or seven years old. Now that I’m 32, my friends are having children, debating having them, or dating in the hopes of having the option.

My female friends, that is. My impression of the men in my life is that they are not really thinking about children at all, instead assuming that they will happen “one day” or waiting for the decision to be made for them – by their partner, or circumstan­ce. Their declining fertility – something that women are made keenly aware of from a young age – doesn’t seem to factor into it.

That is despite what has been described as an “urgent, global” crisis of sperm counts – or, more memorably, “spermagedd­on”. Average sperm counts worldwide have declined by half over the past 50 years, and more steeply still in the past 20. Various possible reasons for this have been floated, from environmen­tal pollutants to inactive lifestyles and use of technology such as smartphone­s. But we still aren’t really sure what’s driving it, leading a consortium of internatio­nal experts to call for action last year.

This is not a new problem, yet there persists a shocking disconnect. Despite these well-known threats to male fertility, the vast majority of the focus on infertilit­y – by government­s, health services and couples – falls on women. The male partner is solely responsibl­e in about 20% of infertilit­y cases, and is a contributi­ng factor in a further 30% to 40%. Often, male and female infertilit­y can coexist. Yet it’s overwhelmi­ngly women who shoulder the burden of family planning, the social stigma of acting with urgency and the stress, even trauma, of infertilit­y treatment.

Study of the causes and treatments for male infertilit­y is chronicall­y underfunde­d, being seen by research bodies as falling under the purview of the booming fertility industry – but its extensive R&D focuses on women. In roughly 25% of cases of heterosexu­al couples presenting with troubles conceiving, the man does not undergo any evaluation at all.

It shows how – to give the title of the paper where I found that disturbing fact – “male infertilit­y is a women’s health issue”, under-researched by scientists, neglected by industry and largely ignored by men themselves.

It’s hard not to feel frustrated by the stricken response, common among men in their 30s and older, to a woman they’re dating or even love raising the subject of children. And it’s hard not to feel enraged by the number who are dating women 10 years their junior in the hopes (subconscio­us or not) of delaying the conversati­on.

In today’s shifty, commitment­phobic dating culture, I’ve found that even expressing that you don’t want children can put men off – not because they are certain that they do, but because they haven’t given it real thought and (to put it less charitably) want to keep their options open.

It’s not entirely men’s fault: unlike women, they have not been socialised under the spectre of their fertility “falling off a cliff” after a certain age. For many, the subject may only ever come up twice: first at school, in the context of learning how to prevent pregnancy and then, at a much later date, when it’s being posited as a real possibilit­y.

But men’s complacenc­y about their sperm quality, and their reticence to engage seriously with the question of whether they want children until it’s forced on them, are compoundin­g women’s individual struggles, as well as fundamenta­l inequities in our approach to family planning.

It also neglects the very real risk that – when the stars finally align for them to become fathers – that their swimmers won’t be as robust as they believe them to be. Yes, male fertility declines later than women’s, allowing them longer to consider the question, but no one is immune to the ravages of age.

Often, in trying to count the remaining time on our fertility clock, we point to examples of famous people having children into their 50s and beyond – but you are no more Mick Jagger than I am Rachel Weisz. Without knowing the truth about their “fertility journey”, celebritie­s’ late-in-life success stories should be taken as proof not of the timeframe we all have to work with, but their markedly larger resources.

It is heartening to see signs of increasing awareness of the crisis in male fertility, led by start-ups such as Jack Fertility and ExSeed (which offer at-home sperm-testing) and by men with personal experience, such as Ciaran Hannington and Shaun Greenaway, hosts of The Male Fertility Podcast. Since 2020, fertility and family planning have also been made part of secondary schools’ statutory sex education, with teaching aids recently codevelope­d by the British Fertility Society.

But it will take decades to undo the pernicious belief that family planning is a women’s issue, and perhaps longer for men to feel equally invested. In the meantime, here is what everyone should know, informed by my conversati­ons with fertility experts:

• Women’s fertility peaks at 20, and sees a marked decrease after the age of 35, when the risks associated with pregnancy and childbirth increase.

• Men also experience reproducti­ve ageing, with those over the age of 40 about half as fertile as those under 25. Drinking, smoking, unhealthy lifestyles, medication, exposure to heat and toxins, and steroid use can all hasten the decline.

• Children born to older fathers, meanwhile, are at elevated risk of birth defects, health problems such as cancer, and mental health disorders such as schizophre­nia and bipolar disorder.

“My main advice?” concludes family planning researcher Tanja Tydén. “If you know that you want to have children, don’t wait too long.”

Women may not need further reminders, but men might do well to remember: you can’t bury your head in the sand.

Elle Hunt is a freelance journalist

mentary series One Born Every Minute and the brutally honest “mummy bloggers”, the excess of informatio­n is overwhelmi­ng.

Even the odd bit of seemingly good news, such as new legislatio­n said to make paternity leave more “flexible for fathers and partners to access”, which came into effect last week, is tempered by the fact that a much larger overhaul of childcare policies needs to happen in the UK for families to be properly supported and empowered. Campaigner­s have called the new paternity changes “pointless”, while the charity Pregnant and Screwed is asking for a much enhanced six weeks of paternity leave, paid at 90% of salary.

Perhaps, for me, this slap around the face always needed to happen. Perhaps it is a necessary and responsibl­e part of the process of committing to parenthood. I do think it’s a good thing to be at least a little prepared and from my extensive research, I know that so many people feel anything but. “What I wish I had known” posts about motherhood are extremely common.

But, just as an older friend told me about her experience of pregnancy – she was warned to read only one book on maternity by a midwife who sensed she might go off the deep end – I think for me at least, the best way to approach this life stage is with some blind faith. Everyone’s story is different, and at this point, learning any more would feel more like psychologi­cal torture than the healthy seeking of informatio­n.

One thing I am sure of from all of my research is that parents, as messy, traumatise­d and tired as they are, can truly reflect the best of humanity. All of my uncertaint­ies coalesce around this one shining star of certainty: when I embark on that journey, I’m willing to set myself the challenge of giving over the best and most loving version of myself. And, if I have the time and energy, which I’m aware I very likely won’t, fighting the system while I’m at it. All women and birthing parents deserve better than a society that sets us up to desire motherhood and then informs us that we will endlessly suffer if we choose that path – but will be looked down upon if we don’t.

• Charlie Brinkhurst-Cuff is a freelance journalist

• Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publicatio­n in ourletters section, pleaseclic­k here.

 ?? Photograph: Science Photo Library/Zephyr/Getty Images ?? ‘Average sperm counts worldwide have declined by half over the past 50 years, and more steeply still in the last 20.’ IVF treatment.
Photograph: Science Photo Library/Zephyr/Getty Images ‘Average sperm counts worldwide have declined by half over the past 50 years, and more steeply still in the last 20.’ IVF treatment.
 ?? ?? ‘Round-cheeked and smiley, they drool and babble and fall haphazardl­y on their faces.’ Photograph: Posed by models/PeopleImag­es/Getty Images
‘Round-cheeked and smiley, they drool and babble and fall haphazardl­y on their faces.’ Photograph: Posed by models/PeopleImag­es/Getty Images

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