I recently received some wonderful insights from Mandy Rodrigues (Clinical Psychologist) who so generously agreed to write the following article on Male Infertility.
MYTHS ABOUT MEN AND INFERTILITY
By Clinical Psychologist, Mandy Rodrigues
Infertility is a universal problem that impacts many people across the world. It is also a growing problem in spite of medical science developing new methods daily for improving treatment. There are some common myths, shared by men and women alike about male infertility. These myths seem to transgress cultural boundaries, and appear to be universal.
Myth 1: Infertility is a female problem
While this belief is widely held, it has no factual basis. One too easily assumes that infertility is a female problem. However, in nearly a third of all infertility cases, a male factor is the main cause. The most well-known causes of male infertility include: damage to the testicals from infections like mumps, genetic problems, failure of the testicles to properly descend, damage caused by chemotherapy and radiation, or the loss of a testicle due to torsion or trauma. Further possible complications include the tube from the testicles carrying the sperm, being blocked due to a sexually transmitted group of infections, and in some instances, men are actually born without the vas deferens tube.
Myth 2: The more we have intercourse, the higher our chances
One assumes that the more one has intercourse around time of ovulation, the more sperm, and the higher the chance of a pregnancy. However, having intercourse every day can lower the sperm count significantly. Every other day is probably a better option. Similarly, abstaining for long periods of time, does not improve the store of sperm. In fact, after three days the quality of the sperm starts decreasing somewhat.
Myth 3: If I am producing semen, then I must have sperm
This is a common perception. However, one must not confuse semen with sperm. Semen is the fluid in which the sperm swims. The white thick creamy fluid is just a vehicle for the sperm to survive in until they reach the egg. A healthy male has millions of microscopic sperm in each drop of semen. To have spontaneous conception the sperm count should typically be more than 10 million and the sperm motility should be more than 40%. In instances where a man has no viable sperm in their ejaculated sample, a fertility specialist will proceed with a testicular biopsy procedure to extract a small amount of tissue from one testicle, which can be used to fertilise the egg.
Myth 4: I cannot have a vasectomy reversed
A vasectomy is considered a form of permanent birth control. During the procedure, each testicle is cut or sealed to prevent the release of sperm. Fortunately, a reversal can be effective in a huge number of cases. And if a reversal is not possible, there are other more invasive options available. One would need to consult with a specialist urologist to ask about further options.
Myth 5: If I am battling to have children, I am not a man
It is sad when virility and fertility are placed on the same continuum. Even though there is a common perception that one’s ability to have children is linked to one’s masculinity, fertility and sexual function; fertility and sexual function are not related. There are certain rare instances where this might be the case, as with severe hormone deficiencies, physical injury or drug usage. But these are very rare.
Myth 6: If my wife just relaxed, she would fall pregnant
When you tell someone to relax, it is impossible to obey. The relationship between stress and fertility exists, but it is not as simple as that, or as direct as that. Infertility is a disease, and has a physical component as well as an emotional component. To tell someone to relax, will simply stress them more and be counter productive. Support and empathy help; as well as a plan forward with some hope. If she is struggling, let her go speak to someone. There is help and courses are available; as well as therapists who specialise in the management of infertility.
Myth 7: It’s so easy for other couples to conceive
While you are going through the process of trying to have a child and battling, it does feel like everyone else is falling pregnant easily. The fact is that one in 10 people are battling to conceive, and even when a couple is absolutely healthy, they only have a 25% chance every month of conceiving.
Myth 8: Does going to a fertility clinic means we have to do invasive treatment like IVF?
This is a common misperception. Firstly, just because a couple has been struggling for only a few months, it doesn’t mean they can’t go seek a specialised opinion. By seeking this opinion in the beginning, the basics can put right so that conception happens quicker. Medical assistance should be considered in couples under 35 who have been trying to conceive for over a year without success, or after six months in women over 35. There are very few clinics that only do IVF, and most have a variety of less invasive options that they start off with and if conception difficulties are not identified, then more involved tests are done.
Myth 9: Fertility treatment will cause marital difficulties.
This myth is closely related to the idea that if intercourse is timed, a couple’s sex life will dwindle. Fertility treatment does not cause marriage problems. A marriage that is already vulnerable and then discovers a fertility problem is at risk for developing difficulties regardless. In many instances, couples report feeling closer to one another during fertility treatment, as they become more intent on trying to preserve the strength of their marriage through a period that would really test the strength of their love and commitment. A major challenge that couples do face is that the male partner will expect a quick solution and will want to fix things; while all the female partner wants is somebody with whom she can talk. She doesn’t expect a quick solution. When the two are not on the same page, they withdraw from one another and this is not a unique problem. Fertility treatment need not cause marital difficulties but rather a time of closer intimacy. Couples are encouraged to seek some professional help if need be.
Myth 10: Men can have children no matter what age they are
Even though Charlie Chaplin fathered a child in his seventies, and we see many older men fathering children with their second younger wives, men also have a biological clock. Not only does the genetic DNA start showing more problems such as in birth defects but the longer one lives, the more one is exposed to the environment and lifestyle factors. Recent research is showing strong evidence for lifestyle factors contributing to male factor infertility such as smoking, obesity and stress. However, the good news is that these can be managed.
Infertility is a journey for both parties, even when the problem lies only with one individual. Women tend to think men are indifferent to the process ahead, and disinterested. But in reality, they are just less likely to discuss their concerns with their wives for fear of causing unnecessary upset. A strategy of independent coping develops, and the couple tries to cope individually with a problem that is easier to deal with when shared.
Hopefully the debunking of some of these myths creates a more accurate depiction of the issue.