Infertility is not a women’s issue

By Khaled Kteily

For the one in seven couples experiencing infertility, the path to parenthood can be devastating. Just recently, comedian Amy Schumer posted photos on Instagram of her painful bruises due to In Vitro Fertilization (IVF), and the outpouring of responses underscores how close to home this struggle hits, particularly for women.

The means through which we have children today has become more calculated than romantic, with women unfairly and inaccurately shouldering most of the burden. By understanding that infertility is carried with equal weight by both women and men, companies need to take a thoughtful approach and demonstrate leadership by offering fertility benefits and options.

The truth about infertility

The U.S. is mocked throughout the world for the astronomical costs of healthcare. By now all Americans understand the medical industry in this country is as much about money as it is about caring for sick, injured, or infertile individuals. Two-thirds of bankruptcies are caused by medical bills. As we continue to depend on an employer-provided healthcare system, there’s little end in sight.

In the last decade, IVF has become extremely popular as more couples struggle with infertility. In fact, a new law in New York  State requires companies with over 100 employees to carry insurance which will pay for up to three cycles of IVF treatment. Other states are eyeing similar laws. While it’s hard to argue with efforts to help couples conceive, the rising popularity of IVF procedures–and its rising support among companies–reflects a dangerous cultural idea that infertility is a woman’s issue. It is not.

In fact, men today are half as fertile as their grandfathers. A recent study from Hebrew University and Mount Sinai medical school shows that sperm counts around the globe went from 99 million sperm per milliliter of semen in 1973 to 47 million per milliliter in 2011, and the declined by almost 60% in the last four decades at a rate of 1% every year with no indication of leveling off.

Broadly speaking, fertility rates continue to drop. In July, The Center for Disease Control (CDC) said the fertility rate fell to an all-time low in the U.S. of 1.72 children per woman. For a population to remain stable from one generation to the next, 2.1 children per woman is needed. So what is happening? There are various non-medical factors at play here that have shifted the social paradigm of couples embarking on the journey of parenthood. Since the 1970s the median age for men becoming fathers has increased by 10 years, from 28.1 to 38.2. That’s largely due to the fact that people are postponing marriage and starting families later in life in order to prioritize work and career.

Corporate America’s role in the infertility dialogue

Companies today are fueling this inaccurate notion that infertility is solely a woman’s problem, by offering benefits that largely disregard the father. Corporate America today offers IVF and egg freezing as selling points for new recruits, but overlooks a cheaper and less invasive alternative: Sperm testing. This isn’t a new trend. Expensive IVF treatments are often recommended by doctors and fertility specialists without a thorough examination of the male partner. While a thorough medical examination is compulsory for women, most men simply have their sperm counted which is only a partial assessment of their fertility. Only one in five men in the U.S. have a full examination alongside their partners despite sperm analysis requiring less effort and costing significantly less than IVF. And historically, prior fertility benefits have been tailored towards straight couples, with many LBGTQ+ employees left ineligible.

A survey showed that of 1,000 employees struggling with infertility, only 29% felt supported by their employers. As a result, over half of the employees who did not feel supported either left their jobs or were actively looking for new ones.

Additionally, an estimated 5% of all companies with more than 500 employees offer egg freezing benefits to employees–a number that is expected to rise. Meanwhile, very few companies today offer sperm testing as a benefit to employees. Offering a broader array of fertility benefits, including ones that acknowledge the father’s reproductive health, not only helps employees feel more supported but fertility benefits can save companies the cost of replacing an employee, which can amount to 213% of their annual salary. These benefits have been shown to alleviate emotional and financial stress associated with undergoing treatment and, consequently, can reduce employee turnover.

This lack of thoroughness and the fact that the average IVF procedure in the U.S. today costs around $20,000 (not to mention it takes an average of 2.7 tries to successfully get pregnant) is an expensive misstep amounting to over $40,000 for successful IVF treatment. It’s time for this to change.

As lawmakers take steps to push companies to help pay for IVF, women are by default encouraged to take on the burden of fertility treatments. Most people know that by delaying conception efforts, women can face fertility obstacles that stem from shifting hormones and egg count. However, it is commonly believed that because men never run out of sperm they can produce children throughout their lives. That is only half the story. As men age, the quality of their sperm significantly decreases due to the fact that men develop a genetic mutation every eight months. With men passing along four times as many mutations as women, it should come as no surprise that children of older fathers are more susceptible to inherit mental and developmental disorders such as schizophrenia and autism.

Our society must wake up and realize that men should be just as present in the fertility conversation. Simply providing sperm testing and freezing the same way that companies provide IVF could help shift the discourse around fertility, as well as help avoid spending tens of thousands of dollars on treatments such as IVF, which may very well be ineffective in the end.

For centuries, the blame for infertility has been solely and unfairly placed on women. It’s time for our culture to be more inclusive, and factor in men when determining fertility issues and solutions.


Khaled Kteily is the CEO of Legacy, a fertility company focused on solutions for men, and studied healthcare and public policy at Harvard University, where he received a full scholarship. Khaled has previously worked at the World Economic Forum in Geneva, where he had his work on the future of entrepreneurship published at Davos.

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