Radio Review: Tackling the Male Fertility Crisis (BBC World Service, Business Daily)

After he had a series of unsatisfactory fertility testing experiences, Mohamed Taha decided to launch his own company Mojo Diagnostics in Lyon, France in an attempt to improve the process of sperm count testing. He spoke to Manuela Saragosa in a recent edition of BBC Business Daily along with Tom Smith of Dadi Inc based in New York City, New York. The programme focuses on how tech start-ups are tackling the crisis in male fertility.

Over the last forty years the average sperm count for men across Europe, the USA, Australia and New Zealand has decreased by at least 50 percent, according to a recent collaborative study between researchers at the Hebrew University Jerusalem and Mount Sinai Medical School in New York. This drop in sperm count has led to at least a third of all infertility cases being caused by men.

Taha co-founded Mojo Diagnostics following a misdiagnosis of chronic kidney disease that required him to undergo regular fertility testing, each time producing a different result. Finding this 'alarming', he co-founded the company that uses artificial intelligence to standardise and ultimately improve the quality of sperm diagnostics. However, working alongside the medical community, Taha feels that very little is being done to deal with the growing issue of male infertility.

Smith, CEO of Dadi Inc agrees, stating that the fertility industry had not really evolved over the last forty or so years due to a lack of understanding and awareness on the part of men, who generally do not see infertility as their issue. Smith believes that it is important that men, like women, are made aware that they have a biological clock whereby both the amount and potency of sperm declines over time.

The problem, he points out, is that unlike the menopause, there is no clear indication of when the male biological clock really starts ticking. As a result, where women are bombarded with information about freezing eggs, men do not tend to consider preserving their sperm and this issue needs to be rebalanced.

Dadi Inc produces home kits that allow men to test the quality of their sperm and store it for later use. Despite, as predicted, the bulk of clients being Millennials around the age of 30, the company has received considerable interest from males in their teens to their 70s. 

When asked, Smith says that funding was not too difficult to come by, raising an initial two million then a further five million US dollars, a situation that he attributes largely to the fact that male infertility is an issue likely to have affected most people to some degree, including those within funding bodies.

This is in contrast to Taha, who says he struggled to raise money for his start-up given the taboo nature of male infertility and current opinion that fertility is fundamentally a female issue. Erectile dysfunction, for example, is a problem that men are keen to remedy, he says, but male infertility is more difficult to pinpoint and is largely ignored by 'investors, clinicians, even men'.

Mylene Yao of Univfy Inc, California, however, believes that now there is a cultural shift in attitudes towards fertility, particularly among Millennials, where both partners are much more involved in fertility testing and treatments, with men keen to help the process along. This in turn has spurred a rise in home testing, which can improve diagnostics and improve fertility treatment. Yao says that it is this change in attitude combined with the availability of technology that has led to the increase in funding possibilities.

Having spoken to the various start-up leaders, the presenter Manuela then turns to the research field to find out how this apparent crisis in male fertility has arisen. Here, she speaks to Professor Richard Sharpe of the Centre for Reproductive Health at Edinburgh University.

Professor Sharpe reiterates the findings of the Hebrew University study that sperm counts have dropped over 50 percent in the last 60 years and that one in six men have a sperm count low enough to lead to (not insurmountable) fertility problems. This, he says, combined with the growing trend of women delaying pregnancy into their thirties has potentially created a 'worrying combination of circumstances'.

The problem is that very often men do not know they have a low sperm count. It can be the consequence of mothers smoking during pregnancy, says Professor Sharpe, but can also be caused by a number of lifestyle factors, such as habitual cannabis smoking, regular alcohol use and diet. Very little attention has been paid to male infertility, due in no small part to the advent of ICSI (intracytoplasmic sperm injection), where sperm, even when limited, is injected directly into an egg. While producing high levels of success in terms of fertility, this is a very invasive procedure and ultimately impacts the resources contributing to our further understanding of male infertility, according to Professor Sharpe.

This was an enlightening edition of BBC Business News delving into the issue of why male fertility has been ignored by the medical community and how this is slowly beginning to change. Given the extensive coverage of female fertility treatments and solutions, in addition to the countless women having to deal with the invasive procedures and emotional turmoil that accompanies fertility treatment, it appears that male infertility may be a huge contributor to the infertility experience generally. Increased involvement of men could remove much of the responsibility that has been placed on women. It will be interesting to revisit this topic in a few years, to see how male fertility research has progressed and the ways in which tech starts-ups are working alongside the medical community.