The Silent Shame of Male Infertility by M. Oaklander
By MANDY OAKLANDER
January 3, 2019
…He started taking fertility drugs to help his testicles recover. But three months later, he still had no sperm. He’d been injecting himself with testosterone because his body could no longer produce it naturally, but his doctor recommended he stop in order to make the fertility drugs more effective.
Now his sperm count is slowly climbing, but his sex drive has withered, along with his energy and 30 pounds of muscle. He has fat in places he never had before, including his breast tissue. He’s become depressed.
On his social-media accounts, Goldman has scaled back on shirtless photos and posts more long-sleeved shots instead. But beyond confiding in his wife, he hasn’t publicly shared what’s really going on. “I have 10-plus thousand people that follow me on Instagram,” he says, “who don’t know who the f-ck I am.”
Infertility is almost always thought of as a woman’s issue, and it’s true that women bear the greater burden of it. They are the ones who ultimately either get pregnant or don’t, and regardless of which partner has the fertility problem, the woman’s body is usually the site of treatment.
In vitro fertilization (IVF), for instance, often requires just a sperm sample from men but a great deal more from their female partners: injections of synthetic hormones, blood tests, ultrasounds.
And yet up to 50% of cases in which couples can’t have babies are due in some way to men. More men are talking about it now, but it remains stigmatized, especially in the U.S.
Men are largely absent from public conversation around infertility, and even those who have looked for support hesitate to identify as someone struggling with male infertility.
….Some men, like Goldman, know why they’re infertile. One of the most common causes is a varicocele; veins in the scrotum sometimes grow too big and tangle, which can make the testicle heat up and impair sperm function. This can often be fixed with surgery.
Certain medications, including steroids and hair-loss drugs, are also known to affect fertility in men, as are obesity and other medical issues. Recent research suggests that age is another contributor–sperm quality, not just egg quality, decreases with time.
…In the three years that Dr. James Kashanian has been practicing urology at Weill Cornell Medicine in New York City, he’s noticed a shift in how men approach the issue.
Couples used to assume the problem was with the woman, jumping to IVF and intrauterine insemination (IUI)–in which sperm is inserted directly into the uterus–before exploring issues with the man. “Now, physicians, patients and couples are more aware of this male factor, and they’re looking to get answers sooner,” he says.
After men leave the doctor’s office, though, they often experience raw feelings: guilt, for being the reason their partner can’t get pregnant with their biological child and for what she’ll have to go through to do so; shame, for not being able to perform the basic feat of reproduction; loneliness, because they feel like they’re the only ones in this situation.
…Finally, he found Mens Fertility Support, through which he and other men can advise one another and commiserate. “Keeping it in is just exhausting,” Hansen says. He’s noticed, however, that most members of the group are based in the U.K. In the U.S., “a guy tends to feel like he has to be the rock,” Hansen says.
“So much of masculinity in America is about being as strong, independent and capable as other men,” says Liberty Barnes, a medical sociologist and author of the 2014 book Conceiving Masculinity: Male Infertility, Medicine, and Identity. “If you can’t get your wife pregnant, you can’t help but compare yourself to other men and feel inferior.”