Men's Health Strategy for England includes infertility

The Men's Health Strategy states that in 30 percent of couples experiencing infertility, factors involving the male partner are the primary cause.

The Department of Health and Social Care described the document as a ten-year vision for how to improve the health of men and boys in England and the actions the government is currently taking to aid this. It comes three years after the government published the Women's Health Strategy for England (see BioNews 1100, 1152, 1181, 1199, 1200 and 1224). The Men's Health Strategy does not contain a specific focus on male fertility but touches on it throughout, observing that alcohol consumption – as well as cancers affecting the reproductive system, such as prostate and testicular cancer – can affect fertility.

'For too long, there has been a reluctance to accept that men suffer specific inequalities and hardships when it comes to their health. This includes male infertility,' a Department of Health and Social Care spokesperson told the Guardian. 'The Men's Health Strategy sets up a strong foundation for improving how we think and act on men's health. It is a bold first step, and we will learn and adapt as challenges emerge.'

However, the strategy does not include any discussion of how diagnosis or treatment of male factor infertility could be improved.

'There's been a neglect of male fertility issues,' Dr Raj Mathur, consultant in reproductive medicine and former chair of the British Fertility Society, told the Guardian. 'At the moment, the number of tests for men that are evidence-based is relatively small. We really need more money to research what the appropriate tests for men are through randomised control trials looking at different interventions to see if they actually make a difference.'

Couples could be undergoing IVF unnecessarily if treatable causes of male factor infertility are not diagnosed. One common cause, varicocele, where enlarged veins near the testicles can impact fertility, is treatable through surgery.

One patient, Toby Trice, experienced fertility issues for years and underwent two rounds of IVF with his wife before being diagnosed with varicocele via a private specialist. The couple conceived naturally after his surgery, and Trice told the Guardian: 'All our friends and family around us had children and we were constantly reminded we couldn't. It was soul-destroying... The basic thing was that I had some sperm, so all the focus and attention was on trying to find the problem with my wife, Katy.'

The report has coincided with guidelines for management of male fertility being published in Australia, which include specific guidance for GPs on tests to be offered (see BioNews 1317a). The World Health Organisation also recently published its first guideline on infertility, which emphasises the importance of addressing both male and female factor infertility (see BioNews 1317b).