Looking Under the Rock of Male Infertility
Raise your hand if you looked under rocks as a kid. What’dya remember finding? Moist dark soil and interesting little critters skedaddling away is what I recall. Earth’s underbelly, teeming with life.
The theme of this year’s National Infertility Awareness Week is “Flip the Script.” Be a voice, break the silence, advocate, pledge and help build awareness of this still silent disease called infertility that’s about half as common as diabetes. To this year’s theme I add: look under the rock with men. You’d be amazed at what you’ll learn about these creatures.
Men are People Too
Women are typically more proactive about not only their own health but also that of their partners. This is particularly true when infertility hits: the female partner initiates the care. In America, this leads to a comprehensive workup for women and a semen analysis for guys. And things take off from there. The other interesting fact is that about 20% of U.S. men experiencing infertility will actually get proper medical care, which includes a history and physical exam by a medical provider, and hormones, genetics or other indicated testing. One-in-five. A definite missed opportunity to take great care of men when they need it most. The hidden underbelly of medicine.
What’s under that rock of male infertility? Diseases like diabetes, obesity, low testosterone, pituitary disorders, infections and cancer. Conditions like varicocele, undescended testicles and erectile and ejaculatory disorders. Exposures like tobacco, pot, hot baths, tubs and smelly solvents. Medications like propecia (finasteride), testosterone, calcium channel blockers and antidepressants. A teeming array of things to be sure.
In fact, a normal semen analysis is no longer sufficient to exclude male factor infertility. In fact, among 25% of couples with unexplained infertility, a more subtle male factor issue can be found when a “deep dive” is taken with sperm DNA fragmentation, epigenetics or other advanced testing. One-in-four.
Do Men Cry?
But alas, there’s more. When you peek under that overturned rock for a little longer, you will find shame, embarrassment, fear, anger and sadness to degrees that you couldn’t imagine among infertile men. Yup, this is the real deal and I witness it every day. Trust me, the quality of life impact of this issue, all by itself, is immense. In the words of one of my patients, “the subject became an 800-pound gorilla that, although ignored, never left the room.”
Care to uncover some rocks with us on this issue? Join me in experiencing how deeply infertility affects reproductive age couples through innovative and emotionally provoking art. Come to our interactive art event and exhibit at Venice Arts in June in Los Angeles, entitled “Reimaging Reproduction.” Help us flip this damned script!