It takes two to make a baby but have we forgotten to talk to men?
Author: Professor Joyce Harper
I work in the Institute for Women’s Health. But have we got our name wrong?
For too long men have been ignored with regards to fertility, infertility and reproductive health. Once their sperm have fertilised the egg, it has all been about the woman. But things are changing rapidly.
Some colleagues in my department have recently published a study – “You did not turn up… I did not realise I was invited…: understanding male attitudes towards engagement in fertility and reproductive health discussions”. The study, led by Bola Grace, interviewed men and women to ask their views views on male and female representation in fertility and reproductive health discussions. They found “Men generally wanted to be involved in childbearing discussions and improve their fertility knowledge. However, they felt they did not have a voice on the topic because discussions have traditionally focused on women.”
In a study carried out by some colleagues also in my department, it was found that almost half of men, (46.9%) had looked at information about planning a pregnancy and preconception care. These findings suggest that when men who were planning a pregnancy with their partner received preconception information, they would be more likely to improve their health related behaviours in preparation for conception.
Preconception health is the health of the man and woman before they get pregnant. There is a growing body of evidence that the health of the man and the women can affect their fertility but also the long term health of their children. If men are obese or lead an unhealthy lifestyle, such as smoking and drinking, it can have an effect. So before any couple start trying to get pregnant, we need to start the conversation with the men as well. My colleague Prof Judith Stephenson has recently published three papers on this in The Lancet.
A man’s general health can also affect his fertility. Optimising a healthy lifestyle may help the sperm fertilise the egg.
When a woman is trying to get pregnant, she may use a method to track her fertile window, such as measuring her temperature, checking her hormone levels with an ovulation predictor stick, or checking her cervical mucus. When ovulation is predicted, the man has got to be ready and willing. Men have reported finding this stressful and it may affect their libido. They can feel like a sperm producing machine. Should we give men a place to talk about how they feel about this?
When trying to get pregnant, it is the woman who does the pregnancy test. But does she involve her partner? I always did my pregnancy tests on my own but I think I was wrong. Sometimes I never told my partner it had failed for days. But another negative result affects men too. Should we involve them more in the conversation?
If a couple have to visit the fertility clinic, I have heard many men say that they felt that they were not in the room during the consultations. Their sperm was checked and if it was OK, the conversation centred around the woman but research shows that male infertility accounts for nearly half of all diagnosed cases of infertility. Male friends have told me that there was very little support for them, and they often did not know the best way to support their partner. Both the man and woman need support when treatments do not work. When couples are having fertility treatment, some men want to stop before their partner does. They can feel overwhelmed by fertility treatment and the failures in the same way women can. They can feel overwhelmed by what their partner has to go through.
About 1 in 5 pregnancies end in miscarriage. Unfortunately it is also another example of where men are often ignored. It happens to the woman’s body but it is also the man’s loss. I have had the privilege of meeting Foz Foster, an award-winning illustrator. Foz and his wife have experienced three miscarriages. His artwork, Pain Will Not Have the Last Word, is an expression of his loss, and aims to challenge the perception that miscarriage “only happens to women”. The image used in this post is part of this work. It has featured in the last two years Fertility Fest events. Foz has been working with the miscarriage association to increase the need for support for men. In a piece in The Guardian – it was reported that “A survey for the miscarriage association’s awareness campaign, Partners Too, has revealed that 46% of those interviewed did not share their feelings for fear of saying the wrong thing or causing their wife or girlfriend further distress. By keeping their emotions hidden, men – and women – are at risk of their work being affected, and may even suffer mental health problems and relationship difficulties.”
In a recent study headed by Dilisha Patel, they explored how men share with one another in online forums, it was found that men will congregate in anonymous online spaces to share with one another, as they feel they have no one else to share with. They feel isolated and stigmatised at experiencing fertility problems. As mentioned, the statistics are fairly high, so why do half of the population feel so alone? Should we be doing more to open up these conversations away from anonymous forums and provide reliable help and support?
I appreciate that the woman has to go through a lot from the first day of her reproductive life, with periods, ovulation, fertile windows, pregnancy and more, but many of these also affect the men in our lives. So we must not forget to include them in our conversations. Do you think we have to talk to men as well? Have you been affected by any of these issues? Should more be done to support men? Do you know of any support groups for men? What do men want?
This piece was written with contributions from Bola Grace and Dilisha Patel.
Read More:
The wonderful annual event, The Fertility Fest, do not forget the men. This year they staged The Invisible Man – https://www.fertilityfest.com/invisible-man-barbican and there is a link to the podcast here https://www.thefertilitypodcast.com/bonus-episode-fertility-fest-the-invisible-man/
The Lancet papers on preconception health can be found here. https://www.thelancet.com/series/preconception-health
Miscarriage Association – Partners – https://www.miscarriageassociation.org.uk/your-feelings/partners/
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