Male infertility matters

Forty per-cent of infertility is due to the male. Forty per-cent! Yet, if you ask most people, they’ll still tell you infertility is mainly a woman’s issue. When a couple is struggling to conceive, the default assumption is often that the woman is the one experiencing difficulty. And unfortunately, stigma around male infertility persists. Many men feel ashamed, isolated, or even emasculated. 

Despite male infertility accounting for almost half of all fertility challenges, resources for men remain limited. Male infertility remains one of the least openly discussed aspects of reproductive health. While women are increasingly encouraged to speak openly about infertility, IVF and pregnancy loss, men are often expected to stay stoic and be the supportive partner, even when they are grieving too. When a couple experiences pregnancy loss, much of the attention and support is typically directed toward the woman, leaving many men to cope quietly and feel pressure to remain strong for their partner.

Male infertility is most commonly linked to issues such as low sperm count, poor sperm health, abnormal sperm formation, or the presence of sperm antibodies. In many cases, the underlying cause involves sperm production, or in some instances, a complete absence of sperm. And even with such high numbers, many men still don’t talk about it – and the emotional impact can show up in different ways.

If your partner is struggling to cope, here’s some helpful ways you can support them:

§  Acknowledge their feelings. Don’t assume they’re not finding it painful and difficult, even if they don’t show it. Share the grief with them, ask them how they are feeling, validate their emotions, listen, and provide comfort.

§  Encourage them to talk to someone. If you think it would help, suggest speaking with a counsellor or fertility coach who understands the complexities of infertility.

§  Promote self-care. Men need it too. What are some things they love doing? What brings them joy? A self-care routine can be so beneficial. 

§  Invest in helpful resources. The IVF Dad (by Keegan Prue) is an excellent book. As Keegan says, “The IVF Dad is for anyone, whether you’re a man who wants to better understand infertility treatment; a woman who wants to help her partner be better informed and more supportive; or a couple who wants tips on how to survive infertility”.

Infertility isn’t solely a woman’s issue – men make up nearly half of all cases. Reducing the stigma and exploring options such as IVF, ICSI and sperm donation can improve a couple’s chances of success while helping to ease both the emotional and time pressures involved.

Understanding Genetic Testing in IVF

“About half of all miscarriages are caused by chromosomal abnormalities.” I was shocked when our IVF specialist told us. Fifty per cent felt enormous. But then he added, “We can test your embryos and only transfer the ones without abnormalities.” Now he had my full attention.

By this point, we were meeting our second IVF specialist in Australia. After multiple failed and cancelled transfers – due to my thin endometrium lining – we needed another opinion. During that appointment, he laid out the reality: thin linings are uncommon, often genetic, difficult to treat, and our best chance of having a child was through gestational surrogacy. It was a lot to absorb.

Then he introduced Preimplantation Genetic Testing (PGT-A). And he didn’t mince words: “I don’t treat patients who refuse genetic testing. So it’s your choice whether you want to continue seeing me.” He immediately explained what PGT-A is and why he considers it essential. Within minutes, we were convinced.

Here is an overview:

What is Preimplantation Genetic Testing (PGT-A)?

PGT-A is a laboratory technique used to examine the chromosomes inside an embryo. A healthy embryo has 23 pairs of chromosomes – 46 in total – half from the egg and half from the sperm. When an embryo has too many or too few chromosomes, IVF transfers are more likely to fail, and pregnancies are more likely to end in miscarriage.

By identifying embryos with the correct number of chromosomes, PGT-A helps select the embryo with the highest chance of resulting in a successful pregnancy. Many clinics now consider it standard practice, and research suggests it can increase live birth rates per transfer while reducing miscarriage risk. Although anyone can choose PGT-A, it’s especially recommended for women over 35, as chromosomal abnormalities become more common with age.

Can PGT-A reveal gender?

Yes. Embryos with XX chromosomes are female; those with XY are male. However, whether you’re allowed to know the gender depends on where your embryos are created. In our case, even though our surrogacy transfers were in the United States, our embryos were created in Australia – where revealing embryo sex is illegal. The same restrictions apply in Canada and the UK. In contrast, gender selection is legal in some countries, including the USA, where it has become increasingly popular.

PGT-M: Screening for specific genetic conditions

PGT-M is less common than PGT-A and is used when there’s a known risk of passing on a particular genetic disorder. It screens for single-gene conditions such as cystic fibrosis or Huntington’s disease. In total, PGT-M can detect more than 350 genetic diseases, both common and rare.

PGT-SR: Testing for structural chromosome rearrangements

The third type of genetic testing is PGT-SR, sometimes called PGD. This test looks for structural rearrangements in chromosomes. Some people have the correct number of chromosomes but arranged differently. While they may be healthy themselves, they can pass on unbalanced chromosome patterns to their children, increasing the risk of miscarriage or developmental challenges.

Why many patients choose genetic testing

For us, choosing PGT-A brought a sense of control during a time when so much felt uncertain. After three devastating pregnancy losses, knowing there was a way to reduce the risk of miscarriage offered real comfort. And transferring only euploid (chromosomally normal) embryos gave us renewed hope.

Looking back, I can’t imagine how much time, money, and emotional energy we might have lost if we had continued transferring embryos that had no chance of becoming a healthy pregnancy. Infertility takes so much out of your hands – but genetic testing is one area where you can make a choice that may improve your odds of success.

Thinking about international surrogacy? Here’s what to expect

I still remember the moment our second fertility specialist in Australia told us that surrogacy was our best chance of having a baby. After six years of infertility, several failed and cancelled IVF cycles (due to my thin endometrium lining), and two pregnancy losses, I felt like the ground had shifted beneath me. I had also never met a surrogate, or anyone who’d had children through surrogacy, and I didn’t know what to expect. And while it felt overwhelming at first, surrogacy was an amazing and life changing experience. Because without surrogacy, we wouldn’t have our beautiful son.

Starting the surrogacy path

Once we accepted that surrogacy was our next step, we began researching international options. We spoke with several agencies in the United States. We chose a boutique agency because we instantly connected with the owner and appreciated how hands‑on she was. She guided us through everything — matching us with a surrogate, recommending IVF clinics and lawyers, and helping us understand the logistical, and also emotional, components.

When she sent us two surrogate profiles, I remember feeling a mix of excitement and fear. We Skyped with one of them, Leigha, and within minutes, the anxiety melted away. Talking to Leigha felt like catching up with an old friend. She and her husband Josh were warm and kind and put us at ease right away. That first conversation set the tone for everything that followed.

Building a relationship across the world

Because we were doing international surrogacy, and Australia to the USA is a long way, communication was so important. Early on, we talked openly about what kind of relationship we wanted. We all agreed we wanted a genuine and ongoing friendship, not just a transactional arrangement. Six years later, that bond is still strong.

We also discussed how we’d stay in touch during the pregnancy. Leigha is a wonderful communicator, and not a single day went by without her sending updates through WhatsApp or Marco Polo. We also Skyped into every appointment and scan. One of my favourite memories is when Leigha suggested we record ourselves reading a children’s story so she could play it to her belly each day. Knowing Spencer was hearing our voices before he was even born meant the world to us.

Navigating the practical steps

Alongside the emotional journey, there were many practical steps. We worked with a fertility lawyer who helped us navigate contracts, escrow accounts, and the pre‑birth order — a legal document in the USA that recognises intended parents before the baby is born. We transported our embryos from Australia and worked with the Utah Fertility Center for the IVF transfer. We did the screening process that involved blood tests and medical checks. Finally, we all had mandatory counselling which proved invaluable as we talked through to what expect and anything that was on our minds.

Our first transfer failed. The second resulted in a pregnancy, but we lost our baby around nine weeks due to a sub‑chronic haematoma. It was devastating. Leigha could have walked away at this point, but she was determined to help us. A true angel. Our third transfer (and final one in our contract) worked and nine months later, our rainbow baby was born.

The birth of our son

We travelled to Utah for the birth and had adjoining rooms at the hospital. We had all agreed beforehand that we would be in the delivery room, that my husband Ryan would cut the cord, and that I would have the first skin on skin contact. When Spencer was born, the room filled with tears — relief, gratitude, and so much joy. It was one of the most profound moments of our lives.

The night before we flew home, Leigha gave us a scrapbook she had made documenting our entire journey. From the embryo transfer to the positive pregnancy test to the day Spencer arrived, it was all in there. It remains one of my most treasured possessions. We gave her a necklace engraved with Spencer’s initials, a small symbol of our gratitude for the enormous gift she had given us.

Coming home

Three weeks after Spencer’s birth, we returned to Australia. With the help of our lawyer, we secured his USA passport and citizenship, and once home, we completed the process for his Australian citizenship and passport. Everything went smoothly.

Surrogacy gave us our son. It gave us a family. If you’re considering surrogacy and feeling overwhelmed, I understand. I was there too. But I also know how beautiful and life‑changing the journey can be.