Clinicians report a gradual, but slow, shift in addressing male infertility, with women still more likely to be assessed first when a couple experiences difficulties conceiving. Professor Hussain Alnajjar, a consultant urological surgeon at University College London Hospitals and the Cleveland Clinic London, notes that while it's becoming more common for men to see a specialist before their female partner, particularly if initial semen analysis suggests a problem, overall progress is incremental. "Things are moving in the right direction, but we are still well behind," he stated.
This slow pace of change has impacted individuals like James, 34, from North Yorkshire. After facing challenges conceiving with his wife, James described an "ostrich moment" where he delayed seeking medical evaluation. "Every day, I think about that moment and the time wasted," he said. When his semen analysis results eventually revealed that his sperm were "weak, slow and malformed," he learned he would struggle to conceive naturally. The diagnosis was followed by a two-year delay before a physical examination and hormonal tests, even after seeking private consultation. Despite multiple rounds of IVF, the couple's fertility treatment was unsuccessful.
James expressed the emotional toll of feeling responsible for his partner's pain and the inability to have a child. "You feel you're the reason they can't have a child," he shared. The issue of male infertility is often intertwined with perceptions of virility and masculinity, creating a barrier for some men in acknowledging or discussing the problem. Professor Pacey recalled observing a social dynamic where men at a gathering discussed football while women discussed IVF.
While James did not view his fertility issues as a challenge to his masculinity, the surrounding stigma made it difficult to find support. "It's just you and your partner dealing with this, so it feels like you're an island and there's no-one else out there like you," he said, noting a lack of clear guidance on where to turn or what to say.
Under UK law, fertility clinics are required to offer counseling before treatment, though it is not always free or ongoing. The Human Fertilisation and Embryology Authority (HFEA) has observed that support groups, both online and in-person, are significantly less numerous for men compared to women. However, there are emerging signs that this landscape may be starting to change. Shaun Greenaway, 43, was diagnosed in 2018 with azoospermia, a condition characterized by the absence of sperm in semen. While the exact cause is unclear, he had a severe case of mumps as a teenager, a virus known to be linked to male infertility.
