As I was preparing for our international fertility meetings, and being the guy I am who likes to think big and help others, I embraced this year’s theme: “Focus on the Next Generation.” And then my mind began to wander. If I were given stupidly large sums of money, where would I invest in men’s health research to best ensure that millenials and their gen Z or iGen offspring have long, prosperous and fruitful lives? Well, here’s that bucket list.
To the Nines
- How is male fertility a biomarker of current or future health? This story is unpeeling rapidly, ever since we first published on the topic. Clearly, infertility is a “foot in the door” to men’s health. Why is your sperm count low when it was built to be higher? There are definable, health related reasons for this. It is the male equivalent of the monthly ovulatory cycle.
- Implement strategies to more effectively engage men in their healthcare. There needs to be more dialogue about how best to engage younger men to invest their best asset: health. Be it through cell phones, partners, peers or mentors, it must happen, as men’s lifespans are much lower than that of women.
- Define factors that could influence any decline in sperm counts. Although the true significance of sperm counts trends is debatable, research on endocrine disruption, environmental exposures and social drugs including pot, CBD, alcohol and tobacco must be done to provide answers.
- Develop ways to make sperm from stem cells to help sterile men. Most childhood cancer victims (80+%) are cured and live long lives. But they are also infertile. Given the promise of stem cell technology, it’s evolutionary and revolutionary thinking that will lead us to sperm from skin or other stem cells. Let’s invest here!
- Offer more male contraceptive options for men. Many men want more control over their fertility but their options are limited to vasectomy and condoms. Is the male pill ever going to happen? What about the possibility of reversible vasectomies?
- Define exactly how IVF-ICSI alters natural selection in reproduction. Way more than a million babies have been born in the US through IVF over the last 35 years. Now, close to 2% of all babies are conceived this way. Are they as healthy as their naturally conceived peers? This research needs to continue to better define the true risks of being born in a dish.
- Precisely define the role of testosterone in male sexual health. Everybody’s doing it, but does it really help to take testosterone? And exactly what is helped by testosterone? Remember it’s relatively easy to show benefit, but risks take much longer to demonstrate.
- What are the real risks to offspring for older dads? The “problem” of being an older dad (>50 yrs) has only existed for a generation or two on this planet. Yet the risk to offspring are very real, especially rates of autism, schizophrenia and bipolar disease. We need to better delineate these risks to fully inform older dads.
- More precisely define the state of “manopause.” Many diseases and disorders can produce the signs and symptoms that we classically associate with low testosterone: erectile dysfunction, low sex drive, lower energy levels and fatigue. Give the potential complications of testosterone use, we need to flesh out who really needs it and avoid blanket treatment of any man with symptoms.
Remember, whether we acknowledge it or not, we’re all parents to any and all future generations. In the words of Emerson: “To leave the world a bit better, whether by a healthy child, a garden patch, or a redeemed social condition; to know that even one life has breathed easier because you have lived – that is to have succeeded.”