104 menshealth.com.au
EP AND EMMA met in
en they were both in their
s. “My late father was the
gest of 13 children,” Avradeep
“Growing up, I saw the joy
aising me gave my father. My
s’ dream was to have children,
ey were great parents. I wanted
thing like that.”
Given Emma’s age, the couple
n’t feel that they had the luxury
etting to know each other over
ny years before planning a family,
ey started trying for a baby just
ear into their relationship. “We did
what you’re supposed to do,” recalls Avradeep.
“A slots into B, and Bob’s your proverbial
uncle.” However, despite months of trying,
Emma did not become pregnant. Concerned,
they went to their GP, and both partners were
given several blood tests. Avradeep was also
asked to do a semen test. “I had to produce
a fresh sample and get it to the hospital lab
within an hour,” he says. “Which is no mean
feat, considering the traffic.”
A week later, the results arrived while
Avradeep was playing squash. Emma
collected them and rang him to say they
needed to talk. He returned home, and it was
then that he learned the reason why Emma
was failing to become pregnant: Avradeep had
zero sperm. He was infertile.
It is estimated that infertilit y affects one
in six heterosexual couples and, in 40 per cent
of cases, the cause lies with the man. Despite
advances in health science, the problem is
only getting worse – a study published last
year showed that among men from Europe,
North America and Australia, sperm counts
have halved in less than 40 years. “Men’s
fertility and reproductive health seem very
much to be under threat in our societ y,”
says Sheena Lewis, emeritus professor at
the Centre for Public Health at Queen’s
University Belfast. “A large meta-analysis
published 20 years ago claimed that sperm
counts had dropped in the previous 50 years.
Everybody said the statistics were wrong,
but the paper that came out last year
confirms the data.”
Despite this, the global conversation
around conception still largely centres on
women. “The medical and scientific study
of reproduction has historically focused on
women’s bodies,” says Liberty Barnes, author
of Conceiving Masculinity: Male Infertility,
Medicine and Identity. “So it’s no surprise
that when we started dealing with infertilit y,
this continued to be the case.”
There is, perhaps, a correlation between
this tendency and the way we seem to know
so little about our declining sperm counts.
It’s something we rarely think about as
individuals, unless it becomes a problem. As
for the medical community, it’s aware that
sperm counts are declining – but it’s not sure
exactly why.
“I often compare sperm production to
an assembly line in a car factory,” says Tim
Child, medical director of Oxford Fertility,
one of the world’s largest IVF treatment
centres. “It just takes one bit to go wrong and
the end product won’t be as good as it should
be. It’s the same with sperm: if there’s one
enzyme missing, one protein that’s not quite
right, then it could affect the end result.”
That this seems to be a predominantly
Western phenomenon suggests that the
problem isn’t entirely natural. “It has
something to do with our lifestyle and our
diets,” says Lewis. “We know this because in
countries such as India, richer people who
adopt a Western lifestyle end up having
more issues.”
Many of these Western maladies should
come as no surprise: obesity, lack of exercise,
and so on. Environmental pollutants are a
probable factor, with multiple studies linking
air pollution with “abnormal sperm shape”.
We are also having children later, and sperm
quality is significantly poorer in those over- But there is, as yet, no smoking gun, no
definitive cause. All we have is speculation.
PROBABLE CAUSES
When a couple are experiencing fertility
issues, their GP will most likely suggest a
variety of tests for the woman and possibly
a semen test for the man. They will then be
recommended IVF treatment.
“The reason for my lack of sperm was
never discovered,” says Avradeep. “In
effect, I was discounted as being ‘useful’
by the fertility unit.” According to clinical
embryologist Sheryl Homa, “The triaging
is wrong if a man with poor semen analysis
is simply sent to an IVF clinic. The IVF
clinic offers IVF – it doesn’t offer an
investigation. If you go to a butcher’s, don’t
expect to find oranges.”
Homa used to run IVF labs for both the
state and private sectors, but she quit after
becoming disillusioned with the persistent
marginalisation of men. In 2007, she set
up Andrology Solutions in order to focus on
men’s health – particularly in relation to
their reproductive system. Her hope is to
offer a level of investigation, diagnosis and
explanation that she feels is missing from
the health system.
The men who visit the clinic come alone
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