One of the most gratifying recent developments in infertility treatment has been the way it has lost its social stigma. It is not long ago that IVF mothers worried about confessing even to close friends that a new arrival was a test-tube baby. Today, celebrities such as Gabby Logan and Julia Roberts share their experiences in the lifestyle pages. IVF is commonplace in dinner-party conversation, and any outrage is more likely to be aimed at appalling NHS provision than at women defying nature.

One big taboo, though, still remains. While infertility is both a male and a female problem, with each accounting for roughly half the total burden (one couple in six is affected by infertility), this balance is not reflected in popular culture. Women talk to their friends about their biological clocks, but infertility is not something men discuss much, even with their best mates.

Though infertility or sub-fertility usually has nothing to do with a man’s testosterone levels, and even less to do with his mindset, a feeling persists that admitting to it is tantamount to questioning one’s masculinity. There must be plenty of footballers and actors who have fertility problems. But while rumours are whispered in medical circles about Alist stars, it is hard to think of a male household name who has spoken out about his low sperm count or publicly thanked his consultant for making him a dad.

The result is that the distress suffered by hundreds of thousands of men is endured in isolation, as if it were caused by a sexually transmitted disease. Many remain too embarrassed to ask for help, or to accept that the problem may lie with them and not with their partners.

That is particularly sad because medicine’s capacity to treat male infertility has been transformed of late. Before the mid1990s, sperm donation was about the only option, but that changed with the advent of intra-cytoplasmic sperm injection (ICSI). This technique, in which a single sperm is injected directly into an egg, can allow even men with poor-quality gametes to become fathers. Fertilisation need no longer rely on sperm swimming strongly enough to penetrate an egg. Even when men produce no sperm at all in their ejaculate, doctors can still help, recovering gametes surgically from the testes.

ICSI is so successful that it is used in almost half of all IVF cycles. Whenever there is the slightest doubt about sperm quality, doctors tend to reach for the needle. Birth rates are slightly higher than with traditional methods, and higher still when the man’s partner is otherwise fertile. In many cases, male infertility has become a treatable condition.

What is needed now is for this step change in therapy to be matched by one in social attitudes. Fertility treatment is of course a private matter for everybody, female or male, but high-profile men who have benefited from ICSI should certainly be thinking about going public.

A few celebrity testimonies would give many infertile men the confidence to address an issue that medicine can now do plenty about.

Mark Henderson is Science Editor of The Times

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