Male Infertility

Carly OsmanSo hi, Alex.

Alex WortleyHi there, thank you for welcoming on.

Carly OsmanBefore we dive into the conversation I think is going to be really interesting because it's rooted, yes, in some science because of your background, but also that personal experience. I would love to start there. And if you can tell me who you are and what is your experience with male infertility?

Alex WortleyYeah, so I'm Alex. As you say, currently work in a kind of medical background in marketing. So I work for a private blood testing company. I have done for four years now. So I've developed a good insight into all things, hormone-related health and blood and everything that comes with it. But before that was when the fertility journey started. and i actually worked for a software company. So had no kind of understanding of of all these sorts of things. So it was kind of going in in blind at the time. I live in Nottingham with my partner Lucy and our four and a half year old Connie. So, and we're currently under treatment to try and well help us conceive the child number two, which would be great. but That's kind of where we're at at the minute. So there was some initial infertility, obviously secondary now as well. so that's where where we're at in our kind of fertility journey at the minute.

Carly OsmanFor anyone who's not familiar with the infertility journey, I've been on it. it's It's brutal in many, many ways.

Carly OsmanCan you explain the difference between primary infertility and secondary infertility?

Alex WortleyYeah, so i i mean, I guess it's interesting, obviously, I've let you know that we've obviously got a four and half year old, so we were able to conceive and that actually happened naturally whilst we were exploring IVF options. So that was obviously a wonderful surprise, but I think at the time was, yeah, wasn't expected. We'd gone through some tests just due to the time it had taken to sort of try and conceive, probably on reflection, wasn't actually that long. But I guess when it's your first time around, you're impatient and you don't have an understanding of things. So yeah, we started to go for tests at a fertility clinic, had some results back and had a consultation call with one of the consultants there who'd said I probably had about a 3% chance of conceiving naturally. which was the kind of headline at the time that takes you back and then gets you thinking about things. And obviously not long after that, we yeah found out Lucy was pregnant, which was brilliant. But this time around, it's probably been about two and a half years. say I guess that's the secondary side. Some people might have found it difficult to conceive, but did. And now this time around, I think, you know, we're we're very much on the the kind of IVF journey and and going through that currently just because it's taken this amount of time we've had.

Carly OsmanThank

Alex WortleyWe've, you know, sought advice again from fertility specialists. And whilst they've said, go away and carry on trying for a bit, we're now at the stage where they're more than happy to kind of help and and put things in place.

Carly OsmanI went through fertility treatment probably it's coming up to now a decade ago. And when we went through it, it was automatically assumed that it would be likely my problem.

Alex WortleyYeah. Yeah.

Carly OsmanIt's a female issue. Is that still the case? And how did you find it?

Alex WortleyYeah i

Carly OsmanI suppose on the flip side, being a male in this equation.

Alex WortleyYeah, I don't think it's assumed now. I think it's implied still, though. So if you look at the kind of initial consultation that you'd have for for IVF, so you have to go through some initial checkups, semen analysis, obviously, from a man's perspective. But that is all that is are required as a male in this situation.

Carly OsmanThank

Alex WortleyYou have a semen analysis, that is it. And in the meantime, your your partner is is in the clinic for an hour and a half, having every investigation possible done. As I'm sure you know, kind of blood tests, internal examinations, scans. So that was surprising for me. And this, as I say, was before I kind of worked in private blood testing and and understood more about it. But it was surprising that I had zero requirements. Other than that, there was no kind of health check for me to understand if there's any underlying symptoms. And I guess if you look at that from the external point of view, you'd think, is that because it's still assumed that it is a female issue or is there something else there? But that's that was kind of my initial... sort of thought was this is this is odd why why isn't there more in place to look at something that might be causing by infertility

Carly OsmanAnd then once they found out that it would the the challenge was on your side, did you feel like you had adequate support? Because this was one of my observations when we were going through it. Yes, the problem was well on my end, but my husband was kind of just left to, I suppose, float through the experience. There was no groups. There was no support for him. Are you finding the same thing? think at the time,

Alex WortleyThey've certainly not been signposted anywhere. I think at the time it was COVID, which was another layer of difficulty.

Carly OsmanThe

Alex WortleySo this was kind of mid 2020, full on kind of not allowed to go anywhere type situation. And when we started to explore possibilities, And I guess that added difficulty because it the consultation we had when we found all this out was much like this you know video call where someone had to tell me that news. And I guess difficult for them because it was probably new to them at the time. was probably a consultation that they did in person. But we, yeah, there wasn't much else after that. It was very much if you want to start your fertility treatment, we're here. transfer the money almost. There wasn't any, you should go away and maybe have a look at this or you should go and ask your GP for a blood test or something along those lines. I think this time round, different provider, it seems a lot better. I think there's protocols in place to say, don't do this yet, go away and try again for the six months and do these things such as take supplements, cut drinking completely, for example. don't actually exercise too much which is a funny thing obviously but you know don't over exercise kind of just stay fit and healthy and and balanced so i think that helped but there was none of that on the first first time around and whether that was because of the timing and what everyone was going through and people kind of learning on their feet of online consultations and having to deliver bad news and things like that but yeah there certainly wasn't anything in place even five years ago but perhaps it's improving

Carly OsmanTake me back to that moment on that zoom call so the doctors just delivered this news how old does that make you feel

Alex WortleyYep. Yeah. Yeah, I think I was shocked. I probably, maybe I shouldn't have been. I think I took something close to 13 years to be conceived for parents. So maybe there was a hint there that some kind of genetic issues that I'm probably more aware of. But I think I still just, as most people do, expect things to go well and and go as they're expected to, or as you've seen it go for your friends or family or whoever it might be. but well supported. So my partner's a nurse, so we were able to talk about things quite matter of fact and medically and that they felt support there. But yeah, I think as the initial, oh, this is going to be difficult. And I'd always, always, always wanted to be a parent so think it's always just been on my mind i've grown up around kind of older cousins who who had children and when i was a teenager and growing up they had their babies and i always wanted to look after them and spend time with them and that just felt kind of natural so i think the having to process that idea of maybe not being able to or having to spend a lot of money to be able to was was definitely a shock but I think, yeah, we had that time, you know, we weren't going out much. we were able to talk about it together. There wasn't too many distractions. So I guess I had the time to think about it, which could have been a negative, I guess. But I think I was able to just do a bit of research and kind of understand things a little bit more and yeah talk to each other and support each other with that.

Carly OsmanDid you make it mean anything about you? and I'm going to flip my experience before I hand over to you to answer that question.

Alex WortleyYeah.

Carly OsmanBecause when I found out that I basically was i unable to conceive a baby naturally, i decided that my body was a failure and I had failed at the one thing that basically I was put on this earth to do. And it was a real coming back to self moment where I had to break down a lot of my conditions. also discovered in this thing, I'm a control freak. And I normally if I want something, I go out and get it And for the first time in my life, this whole thing was taken away, there was nothing that I could do other than going through a medical journey to have a baby. Did you feel any of this?

Alex WortleyI don't think I was too hard on myself and now maybe we didn't have time because actually if I flip that around again I think Lucy's very similar she was very much like right we're gonna have IVF that wasn't kind of a we'll just let's just go for it this is you know we know what the deal is we've been told a very matter-of-fact number here a very small number so let's just go for it and we went and kind of explored the kind of funding options for that and and started that process

Carly OsmanYeah.

Alex WortleyI think you start to think back about things maybe have I done something wrong is there you know a diet thing here is there a lifestyle thing that's caused this is there something in the past you know I had a operation when I was really really young that kind of looking back may have caused issues because it was also something I had to have as a child but that could have been something that that led to these these things happening and you start to overthink bits like that but I don't think was anything I could have controlled to say in the same way you did. You said, you know, you wanted to take control of i don't think there's anything that I could reflect on that made me feel bad about myself necessarily. And I had... good support around me to be able to talk about it and that's what I did I kind of I think you're going to probably follow up and ask this but I went into I'm not going to shut up about this mode almost that was my coping mechanism and try and become a little bit of a sort of spokesperson for for this to people around me talking to my friends and and I guess just talking through it and being very open and honest about it so that it didn't become something I was just talking to myself about

Carly OsmanHow did your friends react when you told them?

Alex WortleyAnd So I guess it's interesting timing. I had a few kind of close friends who were maybe about to start a similar journey and were probably starting to go through similar things. It's become apparent really in terms of the circle of friends that this is becoming more and more of an issue for for more people. And we've seen stats for that and fertility rates going down. But it's actually... when we were allowed to go out and kind of socialize again it was good to be able to feel like i could talk to to a close friend group about that and people like say who eventually ended up going through similar processes but again it was at that time where some weeks you would go out the house once or twice you kind of wouldn't talk to people other than who you lived with or people you may be talking to at work online but yeah i had quite supportive team at work at the time as well was quite honest about it then and i've carried on since i think my team members upstairs we were talking earlier i think it's one of the first things i tell people almost now is this this is what i've been through this is interesting this is what i'm going through again now let me tell you all about it let me overshare So maybe that was maybe that was a coping mechanism, but perhaps a surprising one, because I'm sure some people could just shut up shop and and internalize it and overthink it. But I definitely went down the route of just I'm going to make this a bit of my personality almost. That was the way dealt with it. Yeah.

Carly OsmanThat's really reassuring And really, the words just gave you a bit nice to hear, because I think as a culture, we have such a strong link between masculinity and fertility. It's virality.

Alex WortleyYep.

Carly OsmanAnd it's a really warped lens. And I would be worried about demasculization of yourself. So did you not feel any of this at all?

Alex WortleyI don't think I've ever felt particularly masculine so maybe that helped. I've always been quite a feminine person and i think probably touched on that earlier about kind of always wanting to be a parent and be around kind of looking after cousins younger children and things like that or anyone kind of any friends who'd had children always wanted to know have a hold and look after and you know kind of be there to help them so maybe that's just something that's built into me. I spent a lot of time with my mum growing up kind of because of circumstances she was around at home and dad was often kind of traveling and things like that. We'd spend lots of time together at the weekend of the family. But I think I probably spent a lot more time with mom and growing up around her. She did all sorts of things with child care, child minding, kind of adult education and things like that. She was always around sort of school settings. So possibly it's just something that's i've always been there. But no, I didn't. it wasn't where i went to first but i'm absolutely sure it is for a lot of people and i i'm sure that's really difficult as well if you set yourself out so you are quite masculine and you think that's been taken away from you then i can imagine that's really difficult but i think i was probably okay about it because i've never really had those traits or those thoughts before

Carly OsmanThis is a big, massive question, Alex, but how do we change that? Because I fundamentally believe those traits are incredibly toxic, toxic masculinity about it.

Alex WortleyYep.

Carly OsmanYou've got to so look a certain way to be, and you can't see me on the recording, but bunny ears left, right, and center here, but to be a man, you've got to show up in this way. You've got to be barely, you've got to be things. And, and actually it's doing us as a society andnna and an an individual level, no favors whatsoever. What do we need to do to change the conversation around male infertility and it just being one of those things that happens to women and it happens to men?

Alex WortleyYeah, I think, go back to what you were saying, it's bit worrying probably recently that it still seems like such a big problem. I think we've obviously all watched things like adolescence and and kind of obviously the the other podcast drama that's going on currently in terms of Stephen finally possibly being cancelled. Things like that, you know, they're in the news and it's about that kind of masculinity, isn't it? And that was framed all around, you know, how can we fix this? Was it a population...

Alex WortleyDecline and things like that. And it's it's weird that it's still a problem. And I think especially now i have a daughter, you start worrying about all these things that you think maybe were a past generation, but still seem to be such a big problem. I think me doing things like this and carrying on talking about it, I think projects that we've got at work in terms of reframing fertility to be a couple's thing or you know not even couples if you're a man who isn't even in a relationship but wants to know where they're at. kind of take control of that and that that has been my approach to anyone i've spoken to in friends groups is before you've even started to think about this go and have a baseline blood test or a an at-home sperm test just so when you start trying you've got some kind of context because it's very easy and very quick to have these monthly disappointments and start to overthink it but if you've got some kind of context or you know where you're at then you can make lifestyle changes you can make kind of medical interventions and start those conversations early and actually from a from an IVF point of view if you think that's going to be something you need save like that's obviously a big thing for people if they're a year or two years down the line

Carly OsmanYeah.

Alex WortleyAnd they're already impatient and suddenly you've got, you know, 15, 20,000 pounds to save up for or find because you're at that level of kind of desperation. And what do I do now? You know, if you knew from the start that something might be a problem, then perhaps that's something you can kind of work towards. if you know if the and NHS isn't an option. so But no, I think talking in general, like I say, I've got friend group. Thankfully, one of my good friends has been going through IVF and they're expecting their first child now, but that's a situation that was probably five years. So that's person I've been talking to from the start to now. And they found that out kind of just before Christmas. So that was an even longer journey, but we've always talked about it and always kind of yeah being a bit jokey because maybe that's the best way to do it sometimes so yeah having conversations and feeling comfortable and i guess hoping that fertility clinics and healthcare care providers start to make it more of a couples focused or male and female focused thing as well that's yeah that's probably what's the best the best thing that can happen

Carly OsmanYou've spoken about your relationship with Lucy as being one that's very open and transparent and you have that, that open dialogue. Do you think this experience has brought you closer together?

Alex WortleyYeah, definitely. I mean, it was a you know funny time to kind of get together anyway, sort of pre-COVID. We sort of met in 2019. We both had relationships that hadn't worked out. And I think, thankfully, both got to a point quite quickly where we were like, we want to you know spend the rest of our lives together and have children together. And we started probably trying for a baby earlier than anyone would expect someone to when they're in a relationship.

Carly OsmanThank you.

Alex WortleyAnd I'm sure there was some kind of raised eyebrows in friendship groups and things like that. But just knew that's what we wanted to do. And on reflection, it was fortunate that we did. So, yeah, I think it's definitely helped. It's obviously been incredibly difficult as well, more so second time round because there has been such a big gap. You also have a little four-year-old at your hip height saying, you know, make me a brother or sister quite often because she's obviously developed some of the same traits I had in terms of wanting to be quite kind of caring and wanting someone to look after and play with. So that's probably when it's the most difficult. And then also, obviously, you try for a month and then have the same end result for what is what two years two and a half years a long time and kind of a yeah you obviously we then said well let's go back into the kind of the fertility route and we've had our we had a first round and that didn't work out so again you've got a whole other you know scenario to go through and then another kind of emotional scenario to go through. So yeah, we definitely support each other. i think I've always been positive and a positive one. And I think that can be incredibly annoying for her sometimes. And I've had to learn over the last few months that I probably have to sometimes internalize things like that because I think she's not got the same sort of outlook she'd rather think of the worst case scenario and that's absolutely fine and me trying to be Mr Positive all the time actually isn't helpful so I think I've definitely toned that down over the years and that's something we kind of learn off each other right and you do that through going through those experiences you kind of learn what's best and the best way to cope with things and sometimes it's probably just going off in separate rooms and thinking different things but it's still being supportive

Carly OsmanFor someone who doesn't have that naturally open community communicative relationship with one another, what are the types of questions and things you should be asking each other?

Alex WortleySort of From a fertility journey perspective or...

Carly OsmanFrom a fertility and also so an emotional support journey,

Alex WortleyYeah.

Carly OsmanWhat, how do you ascertain that your partner is okay?

Carly OsmanAnd again, I'm going to go back to myself that when I was going through it, I went incredibly inward and went, got into my head and I'm very practical by nature, but I didn't really want to talk about it or I over practicalized everything. And whereas emotionally, I was not in a good place at all, but I wasn't prepared to show that. How do you eke out those things?

Alex WortleyYeah.

Carly OsmanIs there anything Lucy said to you and you've just been like, oh, that was a killer question or a friend said to you and they suddenly had the right words to make it feel better at that time?

Alex WortleyI think sometimes it's not just words, right? I think it can be kind of actually, remember one of my absolute core memories from that initial call we had. So Lucy's not really a kind of, her love language isn't touchy-feely emotional. So and she actually when the doctor had said about 3%, I can just remember like reaching over and like holding my hand. And that was quite a surprise to me. And it's just something I remember. And I think it's probably little things like that. It's like moments where you've got to be there for someone actually sometimes. Like I said a minute ago, talking is probably sometimes the worst thing you can do. Actually just sort of shutting up and being in the moment or just listening is is probably much better. It's taken me a long time to understand that though. And I've been terrible at that in kind of previous relationships in terms of just shutting up and listening rather than trying to give an opinion on everything. So perhaps that's a good piece of advice. Sometimes people don't want to be talked at. It's actually sometimes just yeah being present and be willing to listen and not give too many opinions on things is probably more valuable than actually trying to overanalyze, overthink, come up with solutions. And that's it's difficult for me because I guess in my... job that's something I kind of pride myself on and being able to solve problems at work and as a kind of marketing leader you have to be in that position you know you don't get involved perhaps always in the nitty-gritty these days but you do have to help people in the team when they have got a problem that needs solving or you know something hasn't gone quite right So I'm always like fixer in my mind and that isn't necessarily what works best at home. So it's just, and and similarly, I guess for for me, I think Lucy obviously looks at the the medical side of things and and analyzes things that way and and tries to find answers, whereas perhaps that isn't my initial instinct. So... It's difficult, especially when two very sort of different people in different situations. But yeah, that's kind of our experience and we're still learning, still going through it. Right. So kind of six years later, you know, very fortunate to have Connie, but we're now in our kind of secondary journey and and wanting to complete the family and and yeah move move on from there, I guess, because it would be nice to just not have to worry about these things and and yeah be able to, i guess, to live your life a little bit more. It probably feels like we are. not doing as much as we could be probably altogether sometimes you know going away and things like that because you're thinking about when the next appointment might be or when the next treatment cycle is and and how you know gonna how you know she will feel because you're having to inject yourself all sorts of horrible things and so yeah there's that pause when you're going through treatment i think you just have to set those expectations with each other and friends and family as well

Carly OsmanIt's quite in limbo, isn't it? And I don't think I was, and again, it was 10 years ago, so no one was talking about infertility and the fact that I was going through IVF yeah just felt like the biggest possible taboo.

Alex WortleyYeah

Carly OsmanI remember having a a reaction to the injections and my stomach swelling up to the fact I looked at eight months pregnant.

Alex WortleyYeah.

Carly OsmanBeing in so much pain, having to call a friend, one of best friends and saying, I need you to take me to the hospital. And she's like, why? I hadn't told her I was doing IVF. I look back and I now go, oh what was I thinking? This is ridiculous. But I was, I was ashamed of it. And I would, my advice, and this is going be my, I suppose, last question for you is anyone who's on that journey right now, what advice would it be? And for me, it's all about tell people, talk about it, let people in.

Alex WortleyYeah, well, i'll just go back to what you said there though quickly. Here's the biggest thing as a from a male perspective. We literally don't have to do anything and that can be quite difficult to... there the element of control again. you know You have to go through everything. You have to go through all these horrible things, injections, you know going into sedation to have eggs collected. whatever it might be every stage and we contribute to one very small element of a particular time and that's kind of how we can help out but I think what I've tried to do I guess is make lifestyle changes and not make them be a big thing you know it isn't okay for me it hasn't been difficult to stop drinking you know that's just i'm unfortunate I don't have that addictive personality element that perhaps some people would find that difficult And it's not been difficult to take supplements and spend money on those things and and invest in in health because I've seen a massive difference from the initial sample we had to the sample that produce now. These things are clearly making a big difference. So there's a good starting point is actually make the lifestyle changes as well. don't it's not difficult, don't kind of make it about you in that situation. If you can take control of something and and change the outcome, whether it's sperm quality, sperm health, whatever it might be, do that because that's all we can do. We have no control over anything else. It is you know medically pointed towards women and you have to go through all of the horrible procedures. And then from a yeah communicative point of view, We probably have kept it from some people second time around. think we were trying to, you know, we've had family going through things. You know, my mom had a big operation recently and I didn't tell her until afterwards, for example, that we were going down this route again. That's life, right? Sometimes you have got to protect people and and prioritize what you're talking about. But actually, first time around, we told them straight away. said this is what we're doing this is what we found out and yeah i hope you can be there to kind of support us throughout and say obviously we you know found out not long afterwards that we had conceived naturally which was amazing but they were still in the loop and we were able to kind of keep talking to them about it and same with friends and yeah this this time around kind of shared journeys with people which like say has been helpful you know people going to the same clinic, which is often interesting. It's like, oh, we might bump into each other and kind of being quite jokey about that. But yeah, having a supportive network around you, people that individually you can go off and talk to about things and be honest. and probably have small rants sometimes about each other. I'm sure that happens. I have no doubt that happens, and it's absolutely fine as well, because there'll be something that you haven't dealt with in the right way that someone just needs to go off and vent someone about, and that's all part of it. And I think that's probably part of it as any relationship as well. Yeah, making sure you've got people around you. And like I said, I've been really honest with work as well. That might be an interesting point. I've told kind of, you know, senior leaders that this is something that we're going through. And I think that's important too, so that people know what's going on, what to expect when maybe you don't see myself or you're not the personality that they expect and they're used having around. So i think if you're comfortable doing that, do it. If you feel like you're in the right environment too. And I think that should be encouraged. You know, something that I'm seeing more of across across LinkedIn is, you know, this sort of parenting out loud idea that that Elliot's kind of pushing is is a great idea. And that goes for even when you're trying to conceive as well. I think being open, telling people you've got appointments, you're going to be out for a couple of hours, that kind of thing. where We're in an environment we can be a bit more flexible these days. So take advantage of it. -.

Carly OsmanI've one final question to you and it's quite a probing one.

Carly OsmanSo you mentioned there, we just have to do something. We just have to turn up, show up and drop our sample.

Alex WortleyYeah

Carly OsmanHave you ever felt guilty about this?

Alex WortleyOh 100 yeah but i don't but that probably goes for natural pregnancy and childbirth as well right all of the processes this is not it's just not wired to you know all i've ever done is to try and be supportive in that situation but again there's a a lack of control you completely feel guilty you literally go into your room in the clinic and and do what you need to do and then wait around for 45 minutes and your partner's wheeled back in of heavily sedated kind of not knowing what day it is just doesn't feel and doesn't feel right obviously you know there's some circumstances where men will have to go through sperm retrieval as well so there is that's quite an invasive procedure but it's quite rare But predominantly that is the journey that you'll go through. And yeah, completely. And all you can do is kind of be a supportive partner, right? And obviously for me, that means kind of being around for for our daughter. if If Lucy's not kind of feeling up for for doing something during the day or during a weekend, because you've had your injection and you're absolutely exhausted or whatever it might be. And that's that's the best I can do. And that's that's what I've always tried to do. But yeah, there's there's a big kind of feeling of guilt there, but i don't know i don't know if that will ever change in the process because there isn't another way of and isn't another way of doing it. So I think you've just got to be supportive.

Carly OsmanAmazing. Well, thank you, Alex.

Alex WortleyThank you. Great.