Every day I try my best to help men who walk through our clinic doors achieve the full potential of their reproductive and sexual health. That covers a lot of ground mind you, from counseling on sexual dysfunction, to testing, to actual surgeries like a vasectomy. I also see lots of patterns. The one that kept bothering me – like an itch I couldn’t quite scratch – was the fact I kept seeing infertile men who had other medical issues that, at first blush, seemed unrelated. It wasn’t just a patient here or there, it was all the time.
But the common wisdom has been that male infertility is a benign condition. It is something that occurs in otherwise healthy men, making it harder for them to have a baby, but has no other real health implications.
What we are taught often causes us to look something and see it in only one dimension, when in fact if it were turned slightly differently we would see that there is a completely other side to it. In medicine, breaking out from what is taught, from what is ‘common wisdom,’ is particularly hard because we are a consensus-driven fraternity where the truth can take years to uncover and even then is often inconclusively viewed. You don’t – at least I can’t – just one day see something and suddenly shift the paradigm in your head.
So it took some time for the light bulb to finally go on for me. But when it did, it was an “aha” moment. What if, instead of being a benign condition, infertility was a “window” into men’s health? What if we could look at it as a signal that other conditions could occur or might happen, that are just as important, later in life? If that were the case, could we use it as an early-warning tool to help prevent future disease?
That insight became the hypothesis for a series of studies that I and several of my colleagues at UCSF Medical Center – Thomas J. Walsh, Mary Croughan, Michael Schembri, June M. Chan (a really incredible team that any researcher would be proud to share a challenge with) – put together to understand the link between male infertility and other diseases. The team was meticulous in the design and implementation of the study, and the results were nothing short of astounding.
The results will take some time to explain, so I’ll save them for my next posting.