Prof. (Dr.) Rajeev Sood

They have been trying for a baby for two years.

She has had blood tests. Ultrasounds. Hormone tests. Consultations. Maybe even fertility treatment.

Every month brings the same disappointment.

And yet, nobody has asked the most obvious question:

“Has he been tested?”

This is one of the most uncomfortable realities I see in infertility clinics. When a couple cannot conceive, the woman is often the first — and sometimes the only — person investigated.

She gets taken to the gynaecologist. Her reports become the centre of family discussions. Relatives suggest diets, medicines, religious remedies and stress management. Someone inevitably says, “Maybe there is some problem with her.”

Meanwhile, the husband may sit beside her through appointment after appointment without ever undergoing a fertility evaluation himself.

That needs to change.

Infertility is not automatically a woman’s problem

Male factors contribute to infertility in around half of couples experiencing infertility. Sometimes the problem is entirely male-related. Sometimes it is female-related. Sometimes both partners have contributing factors. And sometimes doctors cannot identify a clear cause.

That is precisely why both partners should be evaluated.

Yet men often postpone testing because fertility gets mixed up with something much more personal: masculinity.

A man may think, “If my sperm count is low, does that mean something is wrong with me?”

No.

A fertility problem is a medical issue — not a measure of masculinity.

I have seen couples spend years going from one treatment to another while the husband’s fertility status has barely been examined. It is not necessarily because men are unwilling to cooperate. Often, nobody has explained to them that their evaluation is equally important.

The test men keep avoiding may be the simplest one

A semen analysis is one of the basic investigations used to assess male fertility.

It can provide important information about sperm count, movement and appearance. If an abnormality is detected, the next step is not automatically IVF or a major procedure.

Depending on the cause, management may involve addressing lifestyle factors, treating an underlying medical condition, correcting certain hormonal problems or considering a procedure when appropriate.

And sometimes, the first test is simply the beginning of finding out what is actually happening.

But there is another problem nobody talks about

The longer a couple waits to investigate both partners, the longer they may spend treating the wrong problem.

That can mean more appointments.

More expense.

More emotional exhaustion.

More arguments.

And, perhaps most painfully, more months of wondering, “Why isn’t it happening?”

If you are a man whose partner is undergoing fertility tests, don’t stand on the sidelines thinking, “Her doctor will tell us if I need to be checked.”

Ask.

“Do I need a fertility evaluation too?”

If you are the couple’s doctor, ask both partners.

And if you are the family member who keeps asking the woman, “What is wrong with you?”, perhaps change the question.

Ask the couple:

“Have both of you been evaluated?”

Because infertility is a couple’s medical journey.

And sometimes, the missing piece of the puzzle isn’t another test for her.

It is the first test for him.

(The author is Principal Director, Urology & Andrology Sciences, Pacific OneHealth)