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Gender stigma has left male infertility unsupported. Until now

Lise Bosch

Lise Bosch

Lise is a South African-born and Aussie-raised creative working as Kiindred's in-house writer and editor. With a journalism degree and experience in the beauty industry, she has a passion for family and lifestyle content. On her days off, she’s finding the latest and greatest brunch spots and trying to work through the longest TBR list known to humankind. It’s a work in...
Created on Mar 25, 2024 · 8 mins read

When Ashwin Ramachandran’s uncle sought IVF treatment in the US, he didn’t realise that it would cost him $80,000.


That was the first moment Ashwin pried into the fences of male infertility. 

The next was when he approached his GP for a conversation about his own reproductive health. Before even qualifying for a sperm assessment, he was faced with a 12 to 18-month waiting period to determine his legibility based on whether he was at risk or had been unsuccessfully trying with a partner for a year.  

It’s a symptom of the broader male fertility stigma. In Ashwin’s words, “You’re going, alright, this is sort of an interesting junction. I, one, don’t even want to have this conversation with my GP. And two, I’m twice more likely to be challenged when it comes to conversations about fertility.” 

For the men who do squeeze past the discomfort, the institutional obstacles ahead cut many off before they can begin.

That’s why Ashwin created Sapyen, an at-home male fertility diagnostic tool that has streamlined the barrier-ridden journey, and pulled back the discomfort of pursuing reproductive health. Men can access expert quality fertility care without the typical hurdles. 

This is huge for fertility health broadly. Because whilst male fertility is a scarce footnote in the reproductive health dialogue, research determines that it’s equally responsible for infertility as female partners. 

 

Half of fertility problems in couples stem from the male factor


The gendering of reproductive health has meant that we’ve only been getting half of the picture. 

As increased documentation of male infertility emerges, stats are revealing that it’s a lot more common than culture has made room for.

According to the Hudson Institute of Research, about one in 20 men report low sperm counts causing infertility, while one in 100 have no sperm count at all. And these numbers are on the rise. 

“In just the past two decades, sperm count has dropped by a staggering 59%. If trends persist, men will be considered infertile by 2045,” says fertility nutritionist Grace Armstrong. 

“Men often find themselves on the sidelines of the fertility conversation. Despite research revealing that a significant 30-40% of infertility cases stem from male factor infertility, and are a contributing factor to 50% of infertility cases.”

Male infertility is equally represented in the statistics but underrepresented in the conversation. 

 


Causes of male infertility


There’s no nifty one-liner to the makeup of male infertility. Just like female infertility, the factors are often interconnected, layered, and complex at their roots. Often, people with male reproductive organs have to undergo physical examination, blood tests, and semen analysis to cover the range of constitutive elements. 

High-level causes of male infertility include: 

  • Sperm production complications: Semen analysis might indicate low sperm count, which lowers fertility potential. Healthy sperm is also dictated by at least 50% of sperm cells being active, referred to as sperm motility.
  • Sperm quality: If the sperm has an abnormal shape or movement (motility), this can cause low sperm count and fertility issues.
  • Blockages to sperm passages: Sperm production and movement could be interfered with by blockages. These may have been present since birth, or a result of vasectomy or injury.
  • Functional problems: Experiencing ejaculation difficulties or erectile dysfunction can make it trickier for the sperm to reach its location.
  • Hormonal difficulties: Male sex hormones are managed by a series of glands, one of which is the pituitary gland. This gland influences hormone production in the testicles, leading to male infertility.

These markers of male factor infertility may stem from broader factors including injury, infection, surgeries, testicular cancer, certain disorders like diabetes or multiple sclerosis, or immune health. Lifestyle factors could also impact healthy sperm.


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The barriers to male fertility support


Stigmas of masculinity

Modern culture is undergoing a deconstruction of age-old narratives on masculinity. There’s a movement away from the bronzed-up, brawny, chief in charge who holds everything and everyone together. Instead, we’re untangling nuance from the male experience to embody vulnerability. 

The sexual and reproductive health of men is deeply tied to gender roles. So much so that perceptions of infertility often imply a failure to become male in society. Studies point out that the label of “infertility” can carry an emotional burden that evokes feelings of isolation, failure, and futility. 

That creates a discomfort that prevents many men from even approaching the concept of infertility. Not only does male stigma challenge seeking help entirely (because needing support allegedly signifies weakness), but it also shrugs shame over an infertility diagnosis. 

So it’s understandable that stopping by your GP for a deep and meaningful on your reproductive health is probably the last thing you want to do. 

Male infertility diagnosis bias

Cultural preconceptions seep into our institutions, and the medical space is one of the most prevalent examples. 

Diagnosis bias against infertility in male partners leads to the fact that 18-27% of the time, a couple facing infertility will only be evaluated from the woman’s perspective. The male partner won’t undergo any infertility assessment. There are very few male fertility specialists, and general knowledge is having to claw itself up to speed to recover the hole left by misogynistic medical research. 

The men who do take initiative in their reproductive health are dawned with clumsy consults and the awkward reality of totally uninspiring sample collections. 

This is where we circle back to Ashwin Ramachandran, and how his experience has changed the tide. 

When Ashwin made Sapyen


Born from Ashwin’s personal encounters with these barriers, Sapyen was launched as a simple, swift, and discreet solution to male infertility testing. 

Developed by sharp expert minds, this starts with a take-home test kit for semen analysis. Walking you through nine key sperm assessment parameters, it ensures a thorough understanding of individual reproductive health (without confusing IKEA-like instructions.) 

Collect your sample in the comfort and privacy of your own home, after building a personal profile through their secure online portal. From here, you send the sample in the prepaid return box provided for their accredited, NATA-certified laboratory to analyse. 

Male sperm samples have a notoriously short shelf-life, so enter Sapyen’s innovative sperm stabilisation medium, SPX72.  It extends the viability of sperm samples from one hour to up to three days, turning them into endurance swimmers. All samples are sent off with express shipping straight to their lab. 

Well-established and reliable semen analysis methods are then completed by a team of top-notch medical experts, creating a test result that is 135.4% more accurate than other competing diagnostics, at a fraction of the cost. 

These results are developed into a detailed 16-page report within 72 hours. Bit of a step up from the standard 12-month wait from your GP, hey? 

The Sapyen science


The final diagnostics in the report will dig into:

  • Sperm count: The higher the sperm production, the better. This number indicates the overall reproductive health and ability to fertilise the egg, compared to normal sperm count.
  • Sperm concentration: A density measurement that determines the richness of sperm in the sample.
  • Progressive motility: Are the sperm weak swimmers or Olympic champions? This pinpoints the sperm that purposefully move forward.
  • NP motility: Even if sperm do swim effectively, they might be running in tight circles. Not super helpful. The NP motility parameter provides a holistic view of the sperm’s overall mobility.
  • Immotile: This one’s for the sperm that show no movement whatsoever. Keeping the number of immotile sperm low is key.
  • Motile count: Combining the sperm count and progressive motility parameters, the motile count conveys the total amount of effective swimming sperm in the sample.
  • Morphology: The shape and structure of the sperm dictate how likely it is to fertilise the egg. If it’s not properly formed, this can hinder its function and navigation.
  • PH levels: This measures the acidity or alkalinity of the semen, as an optimal pH environment protects sperm vitality and protects them from damage.
  • Volume: The total amount of semen produced during ejaculation. The more sperm that get produced, the higher chance that a sufficient number of them will reach the egg.

As you can tell, the semen analysis provides a holistic insight into sperm and reproductive health.  It takes male infertility seriously.

Next steps with Sapyen


Around 90% of infertility outcomes are treatable, and lifestyle factors such as nutrition, weight, exercise, stress, and environmental exposures can all impact the male reproductive system. Sapyen’s report provides personalised guidance on how to work through these factors for your reproductive health. 

From here, you also have the option to dive deep by directly connecting one-on-one with a healthcare expert. Sapyen partners with leading international IVF and fertility centres and works with the same labs used by major healthcare providers, making these test results typically accepted by healthcare providers worldwide. So you can take these results with you on your fertility journey, wherever it leads.

The fertility way forward


Statistically, fertility is half half. But that’s not how it’s understood culturally or medically, to the detriment of both men and women. 

Sapyen is a step (okay, more like a leap) towards an open dialogue about infertility that allows biological men to look into their reproductive health without shame. 

Expert-led, empathetic solutions are the way forward for male fertility, and this is proof. 

Sources: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226946/#:~:text=Consequently%2C%2018%E2%80%9327%25%20of,birth%20of%20a%20healthy%20child

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735147/  

https://www.sciencedirect.com/science/article/abs/pii/S027795360400019X?via%3Dihub 

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/infertility-in-men 

https://www.racgp.org.au/afp/2017/september/male-infertility 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6775564/#bibr38-1557988318820396

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