Phillip Congelliere calls his sperm his “little guys.” He talks about them in a jocular way, though they’ve consistently let him down. In a YouTube video with his friend Mason, part of a series on his family’s adoption process, he makes a cone with their hands to describe how his sperm are supposed to look: pointy enough to pierce an egg. “Mine look like little hammerhead sharks, or at least that’s how I’m imagining them,” Mason admits, weaving his hands together to form a bridge. “They just hit [the egg] and bounce off.”
Male infertility is a topic that’s rarely broached at all, so you don’t expect to see two men in their late 20s discussing it on YouTube. While many TV show plotlines feature women struggling with infertility, men are typically positioned as virile sperminators able to sire children well into old age. The myth of the 85-year-old man impregnating his much-younger honey hasn’t died an easy death.
But Mason and Phillip have pledged to “get vulnerable” in this video, even as they engage in bro-y behavior, giving each other high-fives as Mason talks about his better-than-average sperm count (which, unfortunately, still isn’t enough to fertilize an egg). They appear most stricken when discussing how their infertility affects their wives. “I wasn’t thinking as much about me,” Mason says at one point to the camera. “My thoughts were about how Sarah was dealing with this.”
Around 40 percent of infertility cases these days involve men, whether due to misshapen sperm, low sperm counts or decreased sperm mobility. But while decades of research have focused on how women react to their own infertility, male experiences have been largely pushed aside, “an oversight of considerable proportions,” according to one study.
Today, though, researchers are finally getting hip to the male experience, looking at how infertility affects a man’s perception of his own masculinity and, yes, sense of self-worth. In the U.K., a recent study at the University of Warwick analyzed how social scripts concerning masculinity prevented men from opening up about their inability to sire children. A survey of 22 men found that many repress their feelings in order to not further overwhelm their female partners. “I don’t want to give away how worried I am to my wife… I just don’t want to… add it to her burden,” one of the respondents told the surveyors.
Turning to male friends can also be a minefield. “Masculinity is inherently relational: It is all about men’s relationships with other men and, indeed, women,” says Dr. Alan Dolan, the study’s author. “Regardless of their status, their infertility can potentially always be used to subordinate them.” Dolan adds that this dynamic may even contribute to the dearth of surveys on the topic. “It’s very difficult to recruit men to qualitative studies regarding infertility, which is why it took a great deal of time to recruit the men we did.”
Carole Lieber Wilkins, a Los Angeles marriage and family therapist who focuses on fertility issues, says it’s rare for men to contact her on their own. “There’s no question that it’s difficult to talk about,” Wilkins says. “Societally, male fertility issues tend to be associated with virility and sexual prowess, which is too bad because that has nothing to do with it.”
Typically, Wilkins adds, her infertile male clients suffer from the same insecurities as her infertile female clients. “They question their role with their wife; they question whether she will still see him as attractive; they question whether infertility will affect their sexuality. A lot of their concerns have to do with how they’ll be perceived by society.”
While infertility among women is rendered sensitively in books and film, men have been told their misfiring sperm will lead to the downfall of civilization. In the nineties, after a British Medical Journal found that papers published over a fifty year span pointed to a “highly significant” decrease in sperm, follow-up research appeared to confirm these conclusions and a “consensus began to develop that sperm counts in human males were in decline,” according to a paper titled Masculinity, Infertility, Stigma and Media Reports. Researchers tied the lowered sperm density rate to a rise in testicular cancer and genetic defects that affected the penis, and also floated the idea that estrogen, or “estrogen-like compounds” could be causing the decrease in sperm density.
The media, of course, hyperventilated over this prospect: “[A] Worrying Pattern that Could Threaten the Future of the Human Race,” ran a headline in the Independent in 1998. Other papers were even more creative: “Man Sows the Seeds of Doom,” wrote the Observer. Some of these articles clearly tied sperm to self-worth, drawing unflattering comparisons between infertile men and rodents. “Men are becoming so infertile that they produce only a third as much sperm as hamsters,” the Independent wrote. (It’s no surprise that the book, “Children of Men,” about a dystopian future in which all of humanity is rendered infertile, was published in 1992.)
Today, we still associate a healthy sperm count with the masculine ideal. As a Christian, Congelliere struggled to understand how his condition squared with God’s vision for him. “It’s not romantic — it’s weird, it’s awkward, it’s debilitating and there were multiple times I teared up thinking, how is this the plan?” he says in his YouTube video. He suffered for years in isolation as he tried various fertility-boosting treatments like acupuncture, special diets, pills and supplements. (The website Alternet, for example, lists dubious and difficult-to-follow advice, including avoiding canned foods, not handling receipts, moving your laptop off your lap, watching less TV and turning off your WiFi router.) Support groups exist for infertile men, but online resources are sparse — there’s Mensfe, Fertile Thoughts and Daily Strength, though recent posts are few and far between.
Online resources may appeal to a man’s DIY instincts, but the best advice for anyone who thinks they might be infertile, of course, is to see a doctor. Procedures have improved these days, and ICSI (or intracytoplasmic sperm injection) allows for technicians to take one sperm and fertilize an egg, as opposed to past procedures which required many more sperm for fertilization. “The technology has changed tremendously throughout that time I’ve been in practice,” Carole says. “This is why there’s that expression, ‘it only takes one.’”
It also seems as if diagnosing male infertility will soon become less of a hassle. Recently, researchers at Harvard Medical School unveiled an app that can measure sperm count, concentration and motility (the percentage of actively moving sperm) right on your phone. The system uses a smartphone app with a 3-D printed optical attachment that can record video and analyze the movements of sperm cells in a sample, eliminating the need for an awkward wank in the bathroom of a fertility clinic.
Mason says that when he first found out he was infertile, he felt like his body was betraying him in the most “basic, biological way.” Feeling like a “failed entity,” Wilkins says, is a consistent theme among those who are infertile, whether they’re providing sperm or the egg, but it’s important not to give up hope; it’s all about adjusting expectations. “When people try to conceive they’re fantasizing about the perfect embodiment of the two of them together. When they realize that’s not going to happen, they have to grieve the loss of that fantasized child. A lot of what I do is about helping them say goodbye to that very real person they’ve imagined.”