Or, why science research matters.
But, yup. Incompetent sperm, or, rather, compromised, geriatric or otherwise not up to snuff spermatozooa. Because research into women’s health, women’s sports, women’s anything is so much less than that done on anything involving men’s anything (for example: women’s sports and sports medicine, despite the freakish, hypocritical furor over ‘trans athletes,’ get only 6% of all sports research funding, and you know there’s a whole lotta sports research…), this recent report delighted my soul, and it’s especially a kind of good news for women who have experienced pregnancy loss.
Girl, it’s not your fault. This upends the centuries old narrative (think Henry VIII) that the inability to carry a pregnancy to term is on us, on women, on the pregnant person.
The American Society for Reproductive Medicine recently released its first major update on recurrent pregnancy loss since 2012. One of the most important things it addresses is the contributing male factor, something called sperm DNA fragmentation, which is damage to the genetic material carried by sperm. Two recent meta-analyses found that male partners in couples experiencing recurrent miscarriage had significantly higher sperm DNA fragmentation levels than men in couples without this history. Higher fragmentation has been directly associated with increased miscarriage risk.
When a woman miscarries, especially more than once, the conversation inevitably proceeds along the lines of …was she too stressed? did she push herself too hard? did she eat the wrong thing, sleep too little or too much, gain too much weight or not enough, or work too much, smoke, or use drugs including those legally prescribed? The assumption that pregnancy loss is to be laid directly at the feet of the woman in question is immediate, which means women who experience the loss of, most often, a wanted pregnancy, also endure the quiet or not so quiet accusation of having failed in some way, that her body failed, or – worse – that she did something to cause it.
This painful, harmful sexist assumption is upended by the science, and this new report-slash-update. Yay. Phew. Finally. Incompetent or in some way compromised sperm is a factor. So, what causes damage in sperm? Paternal age, fever, smoking, a history of measles (!!!) or other compromising illnesses, environmental exposures, and a condition called varicocele* are all contributing factors included in the update.
The new and better guidance now says that sperm DNA testing should be always considered when pregnancy losses occur and are unexplained, especially in cases of repeat loss. The report also makes clear that this is not about shifting blame from one partner to the other, but rather is a reflection of scientific reality: pregnancy is a shared biological process, thus, any evaluation of pregnancy loss must and should reflect that shared responsibility.
For years, the medical workup for recurrent miscarriage focused almost entirely on the woman: her hormones, her uterus, her weight, her chromosomes, her lifestyle, her ‘choices’ and yep, surprise: her fault. The men in question – and their lifestyle choices as well as all other factors – were overwhelmingly left out of the conversation. This long overdue rethink and update begins to change that.
If you have or know anyone who has experienced recurrent pregnancy loss with no clear cause(s) ever found, it’s worth sharing this info, or asking your doctor about the possibility of evaluating both partners. That necessary and long overdue conversation is finally supported by the latest medical guidance. Women deserve a complete picture of what’s going on, and y’know what, so do men.
*from WebMD: A varicocele (VAR-ih-koe-seel) is an enlargement of the veins within the loose bag of skin that holds the testicles (scrotum). These veins transport oxygen-depleted blood from the testicles. A varicocele occurs when blood pools in the veins rather than circulating efficiently out of the scrotum. Varicoceles usually form during puberty and develop over time. They may cause some discomfort or pain, but they often result in no symptoms or complications. A varicocele may cause poor development of a testicle, low sperm production or other problems that may lead to infertility. Surgery to treat varicocele may be recommended to address these complications.