There are three main criteria by which male sperm is assessed: volume, mobility and shape. When Russell Davis visited a Harley Street clinic for a test after he and his wife were struggling to conceive, he failed on every count.
“It was disastrous,” says the 42-year-old. “The doctor even asked me if I had ever been exposed to dangerous radiation because it was so bad. I had no family history (of infertility) my parents and brother and sister conceived with no problems. It was such a kick in the teeth. I felt I couldn’t provide my wife with what she wanted that it was my fault and I couldn’t do what every man should.”
By such simple laboratory results, so much of masculinity depends. Perhaps as a result, the issue of male infertility is one rarely broached, even if the cause of 30 per cent of all issues with couples in Britain is a problem with the would-be father. A fact that was noticeable by its absence in maelstrom sparked by professor Geeta Nargund’s comments last week when she said unless women started trying for a baby before they are 30, Britain faced a ‘fertility timebomb’.
However, the hard truths of male infertility remain and the treatment of male infertility has been assessed as a global market now worth several billion euros. Among that “market” in Britain are thousands of men who know all too well the emotional pain, and shame, of being unable to father a child. There is a dearth of research on the actual figure, although estimates suggest some 20 per cent of men will suffer some problem with their sperm production – and as people nowadays tend to wait until later in life to start having a family, the problem is becoming more acute.
“It’s hard to define the scale of male fertility”, says Professor Allan Pacey,one of the country’s leading male fertility specialists who is based at the University of Sheffield. “Men can be really devastated by an infertility diagnosis and many don’t cope with it very well. Women would tend to confide in their friends, parents and sisters about infertility. Men tend not to do that.”
Presently, there is no such “cure”. Couples can either undergo a process called Inter-cytoplasmic sperm injection (ICSI) – which differs from IVF as a single male sperm is chosen to inject in the female egg – or seek a sperm donor.
The latter option is one which Paul, a 41-year-old manager at an arts charity in London and his wife opted for. His infertility was a result of Kallmann Syndrome, a genetic condition, and by his teens he knew he would never be able to father a child. “Really it’s taken me up to now to be able to talk openly, even among a group of other infertile men,” he says. “You grow up in a society where the very essence of being a man is potency and fertility so if you don’t have that it becomes a huge shame that you carry. It really affects your sense of self. It takes a lot of time to admit to yourself you are infertile and share that with other people.”
Those who have become infertile as a result of Kallmann syndrome can have normal sperm potentially restored with specialist treatment, allowing a man to father biological children. The treatment involves hormone injections (gonadotrophins) several times a week and usually takes a couple of years. However Paul and his wife opted to choose a donor together, instead. He says many men take themselves out of the process as they find it too difficult. Two years ago this week she gave birth to twins. The couple celebrated on Tuesday with a long lazy morning off work, cooking American pancakes and playing with toy trucks on the kitchen floor.
“You have to allow yourself to be sad and mourn the children you couldn’t have,” he says. “That can be quite heart-breaking, but it stopped when she gave birth. Children are such mimics; they have facial expressions like mine and stand like me and laugh like me.”
Scientists at the Kallistem Laboratory, a private research facility based in the French city of Lyon, are one group who are examining new ways to tackle male infertility. In doing so, they have now claimed that they have achieved a world first by managing to grow “fully-functioning” human sperm cells from scraps of genetic material.
The process transforms basic male fertility cells, called spermatogonia, into mature sperm in test tubes which can then be used to father a child. It is something which scientists across the world have been attempting for 15 years, but previously have only managed to artificially replicate in mice.
The research has not yet been published in a peer-reviewed journal and as a result is being greeted with caution, for there have been numerous false dawns before. If proven it would be a leap forward of huge significance, however, Spermatogenesis, the process through which the basic reproduction cells develop into sperm, is an extremely complex one. It usually takes 72 days occur in the human body, with a constant supply of basic cells being transformed into mature sperm. Those who have experienced artificial attempts to replicate natural childbirth know the difficulty all too well.
Darren McCluskey, a 43-year-old regional manager for a chemical company who lives in the village of Uphall, near Edinburgh, has been trying – and failing – to conceive through ICSI for over a decade now. His wife’s hormones levels are slightly out of balance while his sperm has poor mobility. The couple have already spent thousands of pounds on treatment both in this country and in Barcelona. This summer, they will undergo another cycle of treatment which McCluskey says is their last chance.
“There are times that creep up on you. You see a father with children in the supermarket or playing football and it grabs you at an unexpected moment.”
McCluskey says the emotional impact of infertility among men was perfectly illustrated during a support event he attended at a private clinic in Glasgow in 2011. There were some 40 couples present and one of the speakers – a psychologist – put all the women in one room and all the men in another for a group discussion on what they were going through.
“We all walked in and stood there looking at our feet,” he says. “The silence was deafening. Nobody wanted to speak. A lot of the guys were relatively new to this and didn’t want to say anything.”
That silence extends to within wider society, too. Dr Liberty Barnes, a sociologist at the University of Cambridge and author of Conceiving Masculinity: male infertility, medicine and identity, says fertility has traditionally always been perceived as a solely female issue. Such is the taboo, that in her native US, documents relating to experimental artificial insemination among veterans at the end of World War Two were destroyed. “If you look at the present day then a lot if this has really continued,” she says. “It has only been the last ten years or so that we have really started talking about this. The focus has been on women for a long time.”
However, miracles do still happen for. None more so than the fact today Russell Davis – the man with the apparently useless sperm – lives in Cornwall with his wife Bevan and their eight-year-old son, Ewan. In 2006, just as they were about to embark on their first cycle of ICSI treatment, his wife conceived naturally.
“I was unhappy, stressed and scared and thought I wouldn’t be happy without children,” says Davis who following his diagnosis quit his job in IT and retrained as a hypnotherapist. “When I let go of all that my wife got pregnant naturally. We did three tests all positive, and couldn’t believe it. It wasn’t until I saw the scan that I thought this is actually happening. I just cried with disbelief.”
For men still battling to have a child of their own, the possibility of hope swimming in a petri dish in a French laboratory, is almost too much to bear.