Sadness and stress are common reactions to finding out you can’t start a family. And even though one in nine Australian couples struggle to conceive, you probably feel isolated and alone. Many men might also be dealing with the shock of finding out they’re the cause —a male factor contributes to infertility in around half of all cases.
Navigating infertility is daunting for couples but can be particularly challenging for men, who feel left out of conversations about fertility, assisted reproductive treatments and parenting in general. There’s lots of information directed towards women, who are the focus of IVF procedures and childbirth, but there’s a gap when it comes to engagement with men. Even though involving fathers in pregnancy care, childbirth and early parenting has benefits for everyone — “There’s often a real sense of helplessness, that [infertility] is not something they can fix or change, and that feels incredibly uncomfortable for men,” Psychologist Narelle Dickinson says.
“Because they tend to take on the role of stoic supporter of [their partner], they don’t tend to be very comfortable acknowledging the impact of the whole experience has been for them.”
Everyone’s experience of infertility is different but there’s some basic stuff that men need to know about fertility services to help them handle the experience. We’ve put together a guide covering everything from coming to terms with infertility to preparing mentally and physically for the road ahead.
The nuts and bolts of In Vitro Fertilisation (IVF)
IVF is one of the more widely known forms of assisted reproductive technology — used to overcome a range of fertility issues — but you might not be aware of the ins and outs of the procedure. It involves collecting a woman’s eggs and a man’s sperm and combining them together in a laboratory to achieve fertilisation. Depending on your situation, IVF can use your partner’s eggs and your sperm, your partner’s eggs and donated sperm, donor eggs and your sperm, donor eggs and donor sperm or donated embryos.
The process for each scenario varies, but the basic steps involve ovarian stimulation and egg retrieval for the female, before insemination, embryo culture, and transfer.
- Your partner’s ovaries will be stimulated with a series of hormone injections to produce multiple eggs; you might help her with this process at home
- When the eggs are mature, they are retrieved via a procedure under light anaesthetic. On the same day you’ll provide a sample of your sperm if necessary
- The eggs and sperm are placed in a culture dish in the laboratory to hopefully fertilise and develop embryos
- The fertilised eggs will be monitored for a few days and may undergo genetic testing at this time
- If embryos have formed, one will be transferred into your partner’s uterus. If there is more than one embryo, the others can be frozen and used later.
You’ll have a two-week wait to see if the embryo implants into the uterine wall, which will be determined by a blood test.
You can learn more about IVF on the Victorian Assisted Reproductive Treatment Authority (VARTA) website.
Coming to terms with infertility
There are plenty of emotions to grapple with when it comes to infertility and, let’s be honest, men aren’t always good at this. Particularly when it’s the bloke’s infertility that’s causing problems with conception.
“When it’s infertility contributed by the male, they often feel incredibly guilty as the bulk of treatment is on the female patient, so they often feel like they’re causing her to go through all sorts of poking and prodding,” Dickinson says. “There’s often a real threat to that sense of masculinity when there’s a male factor contribution, it feels very uncomfortable to be going through all the tests. Depending on your background and your culture, having to provide sperm samples can be an incredibly uncomfortable set of procedures.”
It's best not to bury these feelings — talking to a doctor, sexual therapist or counsellor can help. Your Fertility is also a great resource.
One of the main things to remember is that you’re far from alone.
“Inevitably, amongst their social networks there will be way more people that have gone down a similar path than they could possibly imagine,” Dickinson says. “It’s only often when you say ‘this is what is happening in my life’ to friends and family that other people go oh ‘I had that too’ or ‘we did IVF a couple of years ago and I didn’t talk about it either’. It’s only often through having that courage to speak up and talk about it and disclose what’s going on for you, that the doors to getting a little bit of support and normalising the experience, seem to open a bit.”
Talking about it not only does yourself a favour but helps the next bloke to speak up about the issue and get support.
Preparing for the IVF process
Wherever the fertility issue lays, you’ll want to give your sperm the best chance during the IVF process. There are many things that can damage your sperm, not only impacting your ability to start a family but influencing the health of your baby at birth, and later in life.
Doctor Roger Hart, Professor of Reproductive Medicine Division of Obstetrics and Gynaecology at The University of Western Australia and Plus Paternal advisor, says there are several things men can do to be in the best possible shape for IVF.
“At least three months before IVF [men] must stop smoking, start eating a healthy diet and take a general multi-vitamin,” Dr Hart says. “Gentle exercise is good, minimal alcohol intake and a couple of coffees a day are fine. If overweight, [men] should try to lose the weight around the waist to improve sperm function.”
It’s not just about physical preparation but readying yourself mentally and emotionally for the experience too. Stathi Paxinos, who went through a dozen unsuccessful rounds of IVF with his partner Jo, says they didn’t know how challenging the experience would be.
“I didn’t realise how difficult it was going to be, I didn’t realise how much pressure and stress it would put [my partner] under both physically and mentally, I didn’t realise what was involved in the cycles,” Paxinos says. “It does put a lot of pressure on couples and relationships.”
“It is stressful,” Dr Hart adds. “Their partner will potentially be very emotional during the journey and they will need to provide a lot of support. They must understand many of the things that their partner will go through may be confronting, embarrassing, uncomfortable and potentially distressing.”
It can help to understand IVF success rates.
“IVF often takes several attempts to work,” Dr Hart says.
Success rates for IVF depend on a variety of factors, particularly maternal age – women under 30 have a 40.4% chance of a live birth while women between 35 to 39 have a 24.8% chance of a live birth. Your chance of success also drops with every round of IVF you do.
“Our expectation was that we thought that we’ll go to IVF after a round, maybe two or three, we’ll leave with a baby,” Paxinos says. “It didn’t really occur to us until we were onto our fourth, fifth, sixth failed cycle and we realised oh, this may not be a guarantee.”
What to do during
Some men note that they feel like not much more than a sperm donor throughout the IVF experience.
“For a lot of guys, finding the time to get away from work and other commitments to accompany their partner to appointments can be quite challenging, depending on what industry they’re in,” Dickinson says. “They often feel like they’re not as well informed, they’re relying on their partner to keep them up to date with what’s going on.”
There’s a growing recognition that prospective fathers need to be more included in the system of care — covering everything from language used in resources to timing of appointments. But feeling excluded doesn’t mean you should throw in the towel. Dickinson recommends getting proactive instead.
“I would encourage guys to get to the appointments if they can, as many as they possibly can, if that’s feasible in their work and their lives,” Dickinson says. “Or that may mean they can talk to their partner about involving them in the appointment via Facetime or phone so they can be there to hear it firsthand rather than always feeling outside the process.”
It can also be helpful to plan questions for medical staff together before appointments, take notes during the sessions, and ask your partner open-ended questions if you can’t make the appointment — ‘instead of how was the appointment’ opt for ‘what did you find out during the appointment’.
“Don’t be afraid to speak up and ask questions of the specialists and the support staff,” Paxinos advises. “A lot of these things blokes don’t know about and the best way to get a better understanding and feel involved is to speak up and show your interest.”
Seek out your own information and resources as well.
“There’s a lot of good information put out by the different clinics and agencies, lots of good books that have been written about the experience of infertility. They talk about not only what it might be like and how they can help themselves as individual, but what might be helpful in their relationship or feel like they are better able to support their partner,” Dickinson says. “It’s probably worth them actively seeking some of that information or if their partner brings something home saying you might want to read this, that’s a really good cue. Rather than saying ‘oh no, tell me what it says’. Taking that time to read it and feel like they’re actively part of the process.”
It can help to read up on other people’s experiences – Victorian Assisted Reproductive Treatment Authority (VARTA) has a range of resources including some handy podcasts featuring real couples sharing their stories.
When it gets tough
Keep in mind that the signs you’re struggling might not be buckets of tears or struggling to get out of bed.
“One of the things to look out for is increased irritation or agitation, a shortened wick, things get to you more easily or you find yourself bothered by things that otherwise wouldn’t bug you,” Dickinson says. “Or you find yourself withdrawing a little bit from friends, or friends who have children or managed to get pregnant. It’s often a cumulative thing, you might not be seemingly affected by the infertility experience but if there’s something happening in another part of your life, it might be the straw that broke the camel’s back.”
You might feel like sharing your worries with your partner is burdening them, especially when they’re going through a rough physical experience as well. If this is the case, it will help to chat to mates, family, or a counsellor. There are also plenty of online forums where you’ll find blokes in the same boat with the added benefits of chatting anonymously at home.
However, Dickinson says many female clients often register relief when their male partner shares their worries.
“It becomes much more of a shared experience, it’s not about doubling the burden it’s about sharing the burden,” she explains. “Instead of her feeling like she’s overreacting or reacting in a way she’s not supposed to, if he allows her to understand that he’s also having a tough time, they can support each other. By talking about the fact that you’re having a difficult time, it doesn’t mean you’re failing to be there for her, or you’re doing a bad job, you’re making it much more of a shared experience.”
Paxinos also recommends being open with your partner.
“Talk to each other, don’t feel guilty about things, you’re there trying your best, if it happens that’s fantastic, if it doesn’t you have to get through it.”
He also says it can help to be honest with those around you.
“Don’t be afraid to talk, don’t feel ashamed or worried about what people might think, so many people are going through IVF now. You have to be open about it because it is a struggle, it puts pressure on yourself and your relationship and you need support to get through the process.”
Fertility treatments can be tough on relationships, but they don’t have to be.
“If you go into it as a couple with the idea that we’re going to talk about this and have each other’s back with it rather than one person is the supporter and one supported, we play both roles,” Dickinson says. “That’s when couples tend to get out the other side, no matter the outcome, in better shape.”