Up to 40 per cent of infertility problems can be on the man’s side and yet the focus, particularly in the early stages of investigation, is usually on the woman. Until recently, the only investigation available for a partner was a basic analysis of a semen sample.
Infertility consultations should include both partners. But most infertility clinics are run by gynecologists who are specialists in the female reproductive system and regard the man as a bit of an afterthought. I find women often come to me on their own because their partners say ‘it’s not my problem’. Men emotionally connect virility with fertility and feel somehow ‘less of a man’ if they are not able to give their partner a child. Women seem to be able to distance their emotions a little better from problems with their reproductive system. But ‘it takes two to tango’, as the saying goes, and your partner needs to remember that he is contributing 50 per cent not only to the health of the baby but also to you getting pregnant in the first place.
Your partner should therefore be involved in investigations from the beginning. You may, for example, have a situation where you are both sub-fertile and it is this combination that is causing the problem. If you both had different partners, whose fertility was optimum, you could probably conceive fairly easily. By boosting both your levels of fertility you will have a much better chance of conceiving.
The traditional approach – concentrating on investigating your fertility and ignoring your partner – has some unfortunate consequences. If your partner’s semen analysis is poor, for instance, you may be advised to go straight for fertility treatments without any further investigations, even if you yourself may not actually have trouble conceiving. Both IVF and ICSI treatments require you to take large quantities of drugs, while your partner just provides the sperm sample. So, in effect, you would end up being treated when you do not need to be, because there is a problem on your partner’s side. This is obviously not very desirable and your partner should have more investigations before you decide to embark on what can be long and stressful fertility treatments.
Some enlightened doctors will refer the man to an urologist who specializes in diseases of the urinary system, including the bladder and kidneys. Urologists treat both men and women. And there are a few andrologists who specialize in problems with the male reproductive system.
Even if the problem initially seems to be on your side it could just mask the real cause. Many women who suffer miscarriages, for instance, assume there is a problem with their own reproductive system. But it is logical that, if there is something wrong with the sperm that fertilises the egg, nature will cause a miscarriage. Studies have shown that there is an increased risk of miscarriage when there are sperm abnormalities. This is why it is so important for both of you to get yourselves into optimum health before conception.
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