Providing support for male factor infertility

Issues surrounding male factor infertility are common. About 30–50% of fertility issues in different-sex couples can be attributed to these factors. As a fertility nurse, I’ve seen the negative impact of male factor infertility issues, as well as an all too common lack of awareness around them.

What is male factor infertility?

Male factor infertility is a problem with sperm quality or delivery that makes achieving pregnancy more difficult or impossible without intervention. It may be caused by low or abnormal sperm production or blockages in the delivery of sperm. These symptoms may be due to hormonal issues, genetic disorders, or environmental and lifestyle factors like heavy tobacco or alcohol consumption, drug use, or the use of testosterone replacement therapy (TRT) or anabolic steroids.

How male factor infertility is diagnosed

To diagnose male factor infertility, I recommend patients consult with a reproductive urologist. A reproductive urologist will conduct an examination of the genitals, discuss health history, and request a semen analysis for further testing. Additional tests such as a scrotal ultrasound, hormone testing, and genetic tests may also be recommended. Employers can ensure their teams have access to this kind of care by providing fertility benefits that are inclusive of all, regardless of sex or gender identity, rather than focused exclusively on female infertility.

In addition to consulting with a reproductive urologist, other resources for employees may include:

1. Sperm testing and freezing options

Semen analysis can provide valuable information on semen volume, sperm concentration, motility (how well the sperm move), and morphology (size, shape, and appearance). While sperm issues are a common cause of infertility, among different-sex couples experiencing infertility, the male partner does not undergo a fertility evaluation up to 27% of the time. This lack of testing can lead people down an inappropriate treatment path. As an employer, providing access to reproductive urologists and andrologists as part of your fertility benefits offering can help raise awareness around the importance of male factor infertility testing.

While you may have heard about providing employees access to egg freezing, sperm freezing is also important. In some instances, preservation is essential to future fertility. For example, I have advised individuals with a new cancer diagnosis to freeze their sperm before chemotherapy, surgery, or radiation. In addition, transgender women and non-binary people may choose to freeze their sperm before starting hormone therapy or surgery. As an employer, you can support your trans and non-binary employees by providing them with access to affirming providers and clinics.

2. Education about male factor infertility

In some cases, problems affecting the reproductive organs may cause an infertility diagnosis. However, many people are unaware of how lifestyle factors and health conditions can impact fertility, too. In one survey of men in Canada, while 88% considered themselves knowledgeable about fertility, respondents could identify only half of the modifiable risk factors that impact male fertility. For example, respondents were less likely to be familiar with how obesity, diabetes, high cholesterol, and alcohol consumption can impact fertility.

Some individuals have significantly low sperm counts largely because of their use of testosterone replacement therapy (TRT). Some use TRT intending to increase their libido, build muscle volume, or increase energy levels. However, when they take testosterone supplements, it tricks their body into thinking they already make enough on their own. In response, the signals from the pituitary gland in the brain required for ongoing sperm and testosterone production go down, and the body creates less sperm.

If someone isn’t aware that a certain lifestyle choice or healthcare issue could be a risk factor, they can’t take action to change it. Make sure your fertility benefits include resources — educational content and easy access to fertility experts — to help employees understand lifestyle and healthcare issues that could impact their fertility, and what they can do to address them.

3. Other diverse family-forming options

While fertility benefits may traditionally focus on different-sex couples, it’s important for inclusive workplaces to support the needs of all employees. To be inclusive of all paths to parenthood, make sure your fertility benefits cover:

Gestational surrogacy: People using gestational surrogacy may contribute their own sperm and eggs or use donor materials. It’s becoming more common for same-sex male couples to pursue this option.

Adoption: This is a popular family-forming path, with 21% of all same-sex parents choosing adoption to grow their family.

4. Care coordination

It can be difficult for people struggling with male factor infertility to know where to start, especially since most conversations tend to focus on female factor infertility. Your employees may have questions like:

  • What should my first steps be?
  • What can I do at home to improve my fertility health?
  • What are my treatment options? Is there one that may be more cost-effective but still yield good outcomes?
  • What type of healthcare provider or clinic should I visit?

Fertility benefits that include care navigation support can help employees get answers to their questions and take action based on their personal preferences, circumstances, and goals.

How Carrot can help with male factor infertility

At Carrot, we offer our members multiple resources to navigate male factor infertility issues. When Carrot members first start using their benefit, they receive personalized recommendations on Carrot Experts to talk to, information on finding a clinic, and other resources.

Members also have unlimited access to our Care Team — which is comprised of global benefits experts and fertility specialists — who can provide educational resources, emotional support, and logistical guidance around the topic of male factor infertility. They can also help employees identify high-quality clinics and agencies, easily book appointments, and guide them toward their next steps.

Male factor infertility is a topic that needs more awareness. As an employer, you can do your part by making sure your employees have access to guidance, support, and resources they may need to take the next step in their family-forming journeys.

Want to learn how Carrot can support the fertility needs of all of your employees — regardless of their sex, gender identity, or sexual orientation? Get in touch with us.

If your company doesn't offer fertility benefits, we're happy to start the conversation on your behalf.
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