The Data Is In: Little Care for Infertile Men

Sagrada Familia
Sagrada Familia, Barcelona: What a wonderful place for interesting thoughts (Courtesy Mihaly Koles for

I was hoping my hunch wasn’t true…but it was. A decade ago, while debating with colleagues in Barcelona, I noted a trend in the medical care of infertile American men. Basically, they weren’t getting care. Yes, some were having semen analyses, but that’s about it — and that’s not “care.” Care includes documenting a patient’s medical history, conducting a physical exam, and ordering lab studies if needed.

With the advent of powerful assisted reproductive techniques like IVF, men were being shuttled straight into these avenues, bypassing basic health evaluations, and at alarming rates. This meant that potentially curable forms of male infertility weren’t being diagnosed, let alone treated.

Now, published research confirms all of this, and the trend is more disconcerting than ever.

Missing the Boat

The latest data comes from a large consortium of North American fertility practices that reviewed referrals to male fertility specialists over several years. Notably, among over 4,000 patients reviewed, only 1 out of 5 infertile men actually saw urologists before their respective partners proceeded to assisted reproduction. Not only do these findings agree with my decade-old hunch, they are also in line with what a well-known Toronto fertility program reported seeing in Canada.

Why the Concern?

Maybe this doesn’t concern you. But it should. Here are 4 reasons why:

  • Infertility is a disease just like any other. That means it can be due to exposures, has symptoms, can be serious, and can affect quality of life. What’s more, it also can be treated!
  • Our governing fertility and world health societies recommend that both partners of the couple be evaluated when infertility occurs. A semen analysis just doesn’t cut it.
  • When male infertility has correctable causes, treating those causes is usually more cost-effective than assisted reproduction. And by the way, it can also “cure” the infertility, allowing for baby-making at home instead of in a clinic.
  • It’s now clear that male infertility can be a “biomarker” or barometer of overall health. That means that infertility is a symptom of a larger health issue, like cancer, hormonal problems or diabetes. Infertility also tells us a lot about the future health of men. So, evaluating men early on, when the problem is just infertility, may add years to their lifespans. And that, my friends, is good medicine!

We owe it to infertile men to make sure they have health evaluations: So, get your man checked out!