Thursday, March 28, 2024

TALKING SEX: Wishing to be a father

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“MAN, YOU LIKE YOU FIRING BLANKS.” Imagine being told this by a virtual stranger. Such is the strange and obscene things that some men are told if married or with a partner for some years and no children are forthcoming.

Father’s Day for many men can be a melancholy time as they deal with the fact or possibility that they are unable to give their partner a child. It is still a part of our culture the idea that a man should have a child or certainly a son to perpetuate the family name and most important to prove his manhood.

This issue is very hard for couples and often years of questioning and self-blame takes place. Women usually bear the brunt of attention and focus on the issue of infertility.

However, very little attention is often paid to male feelings about infertility and the social pressure that many men are put under by well-meaning family, friends and strangers.

Some young men have shared that within a year or two of marriage there comes a creeping expectation of the young couple that they will proceed to childbearing. Thereafter, subtle and not so subtle hints begin to take place.

This otherwise private issue can become the subject of discussion or the butt of jokes.

What happens if it turns out that the cause of the infertility is one-sided? More specifically, that the man has a challenge which prevents the production of the right quantity of healthy sperm, or he has something preventing the sperm from being carried from the testicles through the penis to ejaculation or the movement or mobility of the sperm is abnormal and the little fellows just cannot reach the egg.

For some men the causes of infertility may be completely unexplainable. Therefore, even worse than someone saying it to you, many men internalise that feeling that they are firing blanks.

Some men may even explore other partners with the unstated desire to find out if the cause of infertility is their choice of partner. As one guy said to me – “I wanted to see if another ‘chemistry’ will work”.

For those willing to come to terms with what may be happening, the process of testing and investigating can be humbling as it can be very invasive. A man’s genitals are prodded and probed. Questions must be answered about your sexual habits, health problems, injuries and about puberty. Often guys are given a plastic cup and a porn magazine (if you are lucky I am told) and asked to masturbate and ejaculate in a cup.

What is needed is a man’s warm semen so it can be analysed for infections. They are also looking at the sperm for abnormalities in the shape or movement and to count the number of sperm present.

Other tests that may be called for include ultrasounds of the scrotum looking for blockages, or a transrectum ultrasound which checks the prostate and seeks to find blockages in tubes carrying semen. Hormones, urine, and genes may also be tested along with any necessary biopsies.

We do know that there are certain things that increase the risk of male infertility such as smoking tobacco, using certain illegal drugs, being overweight, having certain past sexually transmitted infections, being exposed to toxins, overheating the testicles, being born with a fertility disorder or having a blood relative with a fertility disorder, certain medications or undergoing medical treatments, such as cancer treatment, and performing certain prolonged activities such as bicycling or horseback riding, especially on a hard seat or poorly adjusted bicycle.

This article is to urge men to seek assistance and not to suffer in silence and be weighed down by uncertainty. Too many relationships are strained over the issue of infertility.

The Wednesday evening male clinic at BFPA has well-informed physicians led by surgeon Christopher Warner who are excellent at helping men to assess whether they have a problem and to make referrals.

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