Under-Diagnosis of Male Infertility Drives Couples Towards IVF, Experts Warn
A newly released men’s health strategy in the UK has been met with disappointment by fertility experts who argue it overlooks a critical chance to address under-diagnosis and treatment of male infertility, leading to couples unnecessarily pursuing costly and emotionally taxing IVF treatments. The strategy’s omission of a specific focus on male infertility,despite the existence of successful models like Australia’s,has sparked concern within the field.
Currently, access to specialist care for men’s reproductive health is limited, with most regions having only one or two dedicated andrologists. This scarcity contributes to a situation where male infertility is often overlooked,historically framed as a “women’s health issue” – a perception that persists despite men being able to contribute to infertility even while producing semen,according to Dr.Michael Carroll, a researcher at Manchester Metropolitan University.
“Men shoudl be considered on parity with women,” Dr. Carroll stated. He advocates for more complete assessments, including rigorous testing, detailed lifestyle and medical history reviews, and physical examination of the testes, moving beyond reliance solely on semen analysis. He is currently writing a book aimed at bridging the awareness gap surrounding male reproductive health, noting that men are often less informed about factors impacting sperm quality, such as keeping testicles cool, avoiding tight clothing and hot baths, and the influence of lifestyle choices like smoking, diet, and exercise.
Raj Mathur, a consultant in reproductive medicine and former chair of the British Fertility Society, highlighted the lack of research into male infertility. “There’s been a neglect of male fertility issues,” he said. “At the moment the number of tests for men that are evidence-based is relatively small. We really need more money to research what the appropriate tests for men are through randomised control trials looking at different interventions to see if they actually make a difference.”
The national Institute for Health and care Excellence (NICE) is currently updating its guidelines to recommend increased testing for men, a move described as a “positive step forward” by Tim Shand, founder of the campaign group Men’s Sexual and reproductive Health Matters, though he believes the proposals don’t go far enough.
Compounding the issue is a significant lack of training for general practitioners. Recent research from Fertility Action revealed that 80.6% of GPs have received no education on male fertility, and a staggering 97% would be unable to accurately examine for varicocele, a common and often treatable cause of male infertility.
Shand argues that a more thorough assessment of men before initiating IVF could offer a “significant cost benefit for the NHS,” as well as alleviate the emotional strain on couples.
The Department of Health and Social Care acknowledged the historical reluctance to address men’s health inequalities, including infertility, stating that the Men’s Health Strategy ”sets up a strong foundation” and represents a “bold frist step.” They added that the strategy will be adapted as challenges are identified.
