Male Fertility Appreciation

Fertility appreciation implies respecting the possibility of being able to conceive a child. This appreciation is embodied in methods, models and systems which help women identify those days in which they are more capable of conceiving. Since men do not have a cyclical window of fertility, like women, the various methods of fertility appreciation focus on the woman’s signs. But it is important to appreciate that fertility is a matter of both husband and wife, and the status of the husband’s fertility is relevant to consider when preparing for conception.

How often does a man hear that his fertility has limits? Our contraceptive society effectively generates awareness among males for “responsibly” preventing pregnancy, but seldom would a man be cautioned to care for his fertility, or that there are biological boundaries that could impact his ability to father a child. Men do have a fertility clock, that can reduce their chances of becoming a father as they age.¹

Young adults should be made aware of the benefits of getting married and starting their family before thirty. Sometimes circumstances are not conducive to that, but other times, starting a family is delayed without a full appreciation of the reality of declining fertility. Appreciation in many cases arrives only after experiencing the consequences of delaying parenthood beyond optimal biological times.

When a married couple struggles to conceive, the usual clinical protocol is to first assess male fertility, because up to half of causes of fertility problems are male related. Parameters for male fertility are typically defined in terms of sperm analysis. The assumption is that correcting those parameters will result in a better chance of live birth rate. Do we have enough data to back this up? Sometimes we do not. For example, it is known that despite sporadic sperm seen on semen analysis, some men have succeeded in fathering a child.

Nevertheless, in spite of the fact that the results obtained are limited and its interpretation needs to be nuanced by the limits of the science at this point, sperm analysis remains the mainstream tool of choice.

For a man who has a firm moral conviction against contraception and who believes that the proper place for voluntary genital expression is the loving act of husband and wife, which excludes masturbation for the sake of semen analysis, the solution provided so far has been the use of a perforated seminal collection device (perforated silastic condom) during intercourse. Studies have shown this technique to render results as reliable or even more reliable than usual means.² Still some men object to the use of a perforated condom even when aware that the contraceptive effect has been negated.

The arrival of smart phone apps which analyze sperm in the privacy of the patient’s home offer a means to quantify motile sperm, which has been shown to be a good predictor of fertility. While home apps still might narrowly instruct masturbation as the means to get the sample, the amount required for testing is in many cases small enough to enable the husband to get a droplet from the urethral meatus after the conjugal act or any collectable amount after a nocturnal emission without compromising his conscience.

Could this open a window into male fertility data with higher moral standards?

¹W.C.L. Ford, Kate North, Hazel Taylor, Alexandra Farrow, M.G.R. Hull, Jean Golding, the ALSPAC StudyTeam, Human Reproduction, Volume 15, Issue 8, August 2000, Pages 1703–1708, https://doi.org/10.1093/humrep/15.8.1703²J Gerris, Methods of semen collection not based on masturbation or surgical sperm retrieval, Human Reproduction Update, Volume 5, Issue 3, May 1999, Pages 211–215, https://doi.org/10.1093/humupd/5.3.211