Not the best hill to die on

Men in Merseyside and Cheshire have been told to stop smoking or miss out on IVF. Obviously, they shouldn’t be smoking – but people who conceive naturally aren’t policed like this.

Morning,

Look, this is not the strongest take I’ve ever had: a UK care board wants men to stop smoking to qualify for state-funded IVF. I can already hear people who self-fund their treatment rolling their eyes. But my point is about policing: why should we have our actions and habits so heavily scrutinised before you are able to do what others do without any oversight whatsoever? (Please do encourage your partner to give up smoking, though).

I’ll be back on Friday, when paid subscribers can read about fertility trauma. Do you have it? Upgrade your subscription by clicking the button below.

Emma xxx

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Photo by 231 PROJECT on Unsplash

When my first embryo transfer failed, I was, obviously, devastated. In the instant my pregnancy test showed one line, the child I had imagined, the one I had been whispering hopeful little thoughts to during my two week wait, vanished. For maybe the second time in my life, I was experiencing grief.

But there was another, smaller emotion, too: exhaustion. Exhaustion at the fact that I was going to have to go through this again. More hours on hold to the clinic. More scans. More blood tests and ordering of medication. In short: admin.

We have become better at talking about the grief of infertility in recent years, but it’s not often that anyone addresses the sheer exhaustion of the admin around it. Researching tests, researching clinics, making calls to ensure you haven’t been left off the waiting list – and one of the most onerous parts: the forms.

“Is this normal?” a friend asked recently, after the IVF clinic she had been referred to mailed her a pile of paper that made The Complete Works of Shakespeare look pithy. She was overwhelmed, and a bit panicky, especially by the forms that asked her to think ahead. “I don’t know what I want to do with my embryos after I’ve finished treatment,” she said. “I haven’t thought about it. I haven’t even started yet.”

“Take a deep breath, and do a few pages at a time,” I said. “You don’t have to do it all in one go.”

Reflecting on it, I realised form-filling is one of those things that people who don’t go through infertility simply don’t have to deal with. I thought about that again this week, after it emerged that Merseyside and Cheshire Integrated Care Board, the body responsible for deciding who gets NHS-funded IVF in that area, came out and said it wanted to “equalise’ IVF access by banning male partners from smoking or vaping. For female or carrying partners smoking is, of course, already verboten.

This isn’t, admittedly, a hill I want to die on. There are reams and reams of research showing that smoking – in both men and women – has a negative effect on IVF outcomes, and fertility generally. Sperm concentration is, on average, 23% lower in men who smoke. In short: anyone planning to do IVF should absolutely ditch the fags, and probably the vapes too (although there isn’t as much data on vaping, one study indicated that the effects observed in animal models “suggest that caution should be taken”).

And there are, of course, limits to what state money should be spent on. From a financial/success point of view, asking people to quit smoking is completely legitimate.

But my point is, and please feel free to imagine me doing an incredibly whiny voice here: it’s just so unfair.

People who can reproduce naturally don’t have to prove that they or their partner don’t smoke (before they get pregnant, anyway). They don’t have to fill in reams and reams of forms. They don’t have to take a thousand and one supplements or worry about over-exercising or have anyone police their BMI or drinking or the length of their relationship (or, in some cases, marriage) just to have a chance at conceiving a child. They don’t have to think ahead about what they want to do with remaining embryos. They just get to get on with it. Live in the moment.

It’s unfair that we have to deal with these demands, and the emotional toll that they make. It’s part of what makes infertility so tiring. And if it’s something you’re dealing with right now, I’m sorry.

Some homework

On that note, Katie Rollings, the woman behind Fertility Access UK, is heading to parliament again this week to discuss the state of fertility access in the UK. She’s going to be arguing for an end to the postcode lottery and inclusion of male fertility in the Men’s Health Strategy – and she needs your help.

She’s put together an anonymous survey to help her understand more about men’s mental health when they and their partners are going through infertility. If you have five minutes, you can take the survey here.

And if you have five more minutes, you can use her template letter to write to your MP (you can find out who that is here), or send her your thoughts about why you think male fertility should be included in the Men’s Health Strategy by emailing Katie at katie@fertilityaction.org.

And another thing…

Today (Tuesday) marks 147 days since Donald Trump promised policies to make IVF more accessible in the US “within 90 days”. He hasn’t delivered anything yet, but his supporters – evangelical Christians, the anti-abortion camp and MAHA – have begun to push something called “restorative reproductive medicine” (aka normal reproductive medicine), which focuses entirely on women. But the conversation routinely overlooks a major part of the fertility equation: men. Read more at The Atlantic

Could your partner’s hair-loss pill be giving him a low sperm count? One urologist says Finasteride, a medication used to prevent hair-loss, believes the drug has “significantly affected” some patients’ sperm quality. Read more at the New York Times. (Gift link)

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