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The demand for male infertility drugs is huge. To compensate for the poor quality of their sperm, men are even willing to have expensive and invasive in vitro fertilization (IVF) performed on their partners, reports a leading fertility expert.
For a man, the news of his own infertility is often a devastating and shameful judgment. While male infertility is the number one reason couples in the UK choose IDV treatment, when 39-year-old Craig Franklin was bluntly told he didn't have semen, he felt alone and emptied.
“The general practitioner said: you don't produce sperm, you won't be able to have children. Now get out with you, ”reports the 39-year-old. There was no support at all.
The effects hit him hard and almost caused him to break up with his partner Katie.
“I was angry for a long time. Had fears of existence, ”he tells the BBC program Victoria Derbyshire. "My performance at work has deteriorated so much that I lost my job at the end of last year."
“It broke my heart. I saw a man who was broken, ”says Katie. "He no longer felt like a man and that is so unfair."
Leading fertility expert Prof. Sheena Lewis - chair of the British Andrology Society, with the aim of improving the reproductive health of men - says that the lack of attention to male fertility in the health system is an urgent problem.
"Men are not properly cared for, not diagnosed and not cared for," the researcher continues. The quality of men's sperm in the western world is declining. However, little is known about how it can be improved - and there are only a few treatments that are covered by statutory health insurance.
This leads to the absurd situation that women routinely have to undergo IVF - although there is nothing wrong with their own fertility.
"The woman actually acts as a therapy for the man's problem here," she says. “We give an invasive procedure to someone who doesn't need it to treat another person. This is not the case in any other area of medicine. ”
Prof. Lewis adds that it is also an enormous cost factor for the health system, especially at a time when IVF had to be rationed in many parts of the country.
A couple who had spoken anonymously to Victoria Derbyshire's program might never have had their son if they hadn't looked for other options privately.
By default, they were prescribed IVF - despite the partner's good fertility, but treatment failed due to the man's bad sperm.
“It was really uncomfortable. Spraying with needles that don't go in the first time is not a walk in the park, ”she explains.
The man then went to a private clinic and had varicocele, an abnormality in the scrotum, treated, affecting up to 40% of men with fertility problems. The surgery was even cheaper than the IVF and his wife could get pregnant naturally.
For Stephen Harbottle, an advisory clinical scientist who helped develop the fertility guidelines for the health guard NICE, says: “Because varicocele treatment does not work for every man, the health care system must ensure that other options are explored before a couple an in vitro fertilization is offered. "
This includes simple solutions such as dietary supplements or tests to check genetic sperm damage.
The reason why this is not currently happening is that “Doctors have no other option than to refer patients for IVF. In a way, men are only drawn through the system. ”
Focus on the woman
Some men with fertility problems also report feeling that they are excluded from treatment by primary care physicians who focus on women.
Mark Harper - from Ilkeston in Derbyshire - has two children through donor sperm. But when he was diagnosed with missing sperm, it was his wife that the doctor called with the message, not him.
"When you talk about male infertility problems, you should talk to the man about it," he says. "I'm here, I'm a person, I was the one sitting in front of you, and I'm the one you need to talk to."
The Royal College of General Practitioners (RCGP) said in a statement that its members "are well trained for sensitive, non-judgmental discussions with patients ... including the possible reasons why someone may be sterile and their best options."
Men's biological watch
Prof. Sheena Lewis says the lack of attention to male fertility also means that men are not informed about their reproductive health and mistakenly take it for granted.
“Men have a biological clock. Over time, there are more and more opportunities for mutations in her sperm due to her lifestyle. Men over 45 years of age are more likely to have children who have childhood cancer or psychiatric disorders such as bipolar disorder or autism, ”she says, adding that this is also the case for young men with poor sperm quality.
Katie and Craig say the doctors suspected the reason why they couldn't get pregnant with Katie - she was tested before Craig's fertility was even questioned.
The couple are now looking privately for donor sperm after the IVF denies them.
The stigma surrounding male infertility has meant that Craig has never spoken openly about this topic before - even his friends didn't know it yet.
"You don't talk about that among men," he says. "It is hidden, hushed up."
The couple says it took a year and a half to come to terms with the fact that you can't have children without donor sperm. The worst thing was that they were never offered emotional support. But now they're over it.
"We are stronger than ever," says Katie. “But other couples may not be as strong as we are. You may not be able to get through this and I can understand why. It is so difficult for a man to come to terms with the fact that he cannot give his wife a child. ” (fs)