THE plot of P.D.James鈥檚 dystopian novel The Children Of Men revolves around a provocative thought experiment: what would happen if humans stopped being able to reproduce? In the story, set in 2021, no child has been born in the past 25 years and Homo sapiens is heading for extinction. With no future to plan for, society is spiralling into the ultimate fin-de-si猫cle decadence.
By the time 2021 comes around for real, life may be starting to imitate art. In July, Israeli scientists reported that sperm counts in developed countries have declined by more than half in the past 40 years and continue to fall by about 1.6 per cent a year. 鈥淪hocking鈥� and 鈥渁 wake-up call鈥� were two of the responses from other scientists.
The cause of the fertility crisis in The Children Of Men was a global disease. The cause of ours is not known (see 鈥�We鈥檙e heading for a male fertility crisis and we鈥檙e not prepared鈥�). To say that we urgently need some research into it is not an exaggeration. We are almost certainly not heading for a total collapse of male fertility, but sperm counts are approaching dangerously low levels. Around one in 10 couples already experience fertility problems. And yet our scientific understanding of male infertility remains rudimentary, with some researchers complaining that they struggle to get funding to do the long-term, large-scale studies needed to get to the bottom of the problem.
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For many women, the news that men are suddenly in the spotlight will feel like a welcome role reversal. Difficulty conceiving has long been treated as a 鈥渨omen thing鈥� by society and medicine alike. In the UK, for example, even if a couple鈥檚 fertility problems lie with the man, it is still the woman鈥檚 GP who makes the referral; the man isn鈥檛 even considered to be the patient. Men are also largely exempt from the social pressure of the ticking body clock, even though recent research suggests that this is dangerously complacent.
鈥淒ifficulty conceiving has long been treated as a 鈥榳omen thing鈥� by society and medicine alike鈥�
If the male fertility crisis has a silver lining, it is an opportunity to discuss and redress these long-standing gender inequalities.
Would-be fathers need to be part of this process. In the UK, women鈥檚 reproductive health needs are addressed by the Royal College of Obstetricians and Gynaecologists. There is no equivalent body for men. Men could legitimately argue that this represents an uncommon case in which they are subject to gender discrimination.
But this hand must not be overplayed. Discrimination largely runs the usual way, with women on the receiving end. The way we treat infertility resembles the patriarchy in Margaret Atwood鈥檚 The Handmaid鈥檚 Tale, another dystopian novel with an infertility crisis at its heart, where failure to conceive is routinely blamed entirely on females.
In recent weeks the world has had to confront some sobering realities about women鈥檚 rights. In too many walks of life, women are still not treated as equals: consider the sexual abuse scandals rocking Hollywood, the UK parliament and elsewhere. The science and medicine of infertility are not mired in similar scandal, but need to examine their prejudices nonetheless.
This article appeared in print under the headline 鈥淔ertile territory for change鈥�
