3 Aspects Of Male Reproductive Health We Can't Ignore, From A Fertility Scientist

Pregnancy and fertility challenges still, even today, carry a tremendous amount of stigma and shame for many of the people who experience them. I think this has led to a lot of the silence surrounding these topics, for people of all genders and identities.

As a scientist and fertility specialist, I would like to make it known that at this very moment, there are 186,000,000 walking this planet with fertility challenges. If you fall into this category, please know you are not alone, and you are not broken or flawed. This is a common human experience that is becoming more and more prevalent as a result of the mismatch between the modern world that we inhabit and the world in which our reproductive biology evolved (and, therefore, expects to be functioning in). 

There are three areas of male fertility that I hope will receive much more attention this year:

There is so much attention (almost to the level of hysteria) put on the role of age in female fertility that society and many medical approaches overlook that there is a male biological clock as well. As males get older, the likelihood of fertility challenges and neurocognitive problems1 in children increases.

There are nuanced ways of looking at sperm health beyond the traditional sperm and semen analysis that can give us important information about the likelihood of having a healthy pregnancy and a healthy baby. There are men who are cleared as having healthy sperm2 because traditional measures have shown that they have healthy sperm count, shape (morphology), and motility (movement).

Yet, a more nuanced look might show that there is high DNA fragmentation and alterations in sperm DNA methylation, for example. Genes that are linked to defects with sperm DNA methylation include the MEST, H19, and MTHFR genes—the latter of which is well known for affecting female fertility.

Fertility stereotypes are extremely powerful and so ingrained in society that many don't even realize they exist. Among the deeply ingrained fertility stereotypes that our society holds are the stereotypes of hyper-fertile people of color and hyper-fertile people with fewer socioeconomic resources. What's worse is that these stereotypes are untrue.

Just like with females, males of color are more likely to experience fertility challenges3. Hispanic/Latino and Black/African American males are more likely to experience fertility challenges. These data fly in the face of media portrayals and other stereotypical images of fertility among men of color. Similarly, there is a false stereotype that people with fewer socioeconomic resources are hyper-fertile.

One of the most consistent findings in the health and behavioral science literature is what is known as the SES-health gradient. The SES-health gradient is the relationship of health to socioeconomic status (SES), such that for every level decrease in SES, there is a decline in health. And this includes reproductive health. People who had fewer socioeconomic resources in both childhood and adulthood, and who have faced more adversity in both childhood and adulthood, are more likely to experience fertility challenges.

We need to acknowledge and discuss this more while acknowledging that, even in the face of the hardest of fertility cases, there is almost always a way forward through optimizing the fertility journey and/or medical advancements.

The most important and effective ways of destigmatizing male fertility challenges are awareness and education, especially through the stories of real people whom we love, respect, and admire. Every time, one of those 186,000,000 people who are experiencing fertility challenges at this very moment shares their struggles, we come to understand that fertility challenges are much more common than we were led to believe in health class and that fertility challenges don't discriminate—they affect people everywhere.