Lack of awareness and inadequate testing for male infertility are leading couples to undergo costly and unnecessary in vitro fertilization (IVF) treatments, according to leading reproductive health specialists in the United Kingdom.
Experts say that although men contribute to about half of all infertility cases, primary care physicians often fail to identify treatable causes. Limited access to specialists and incomplete diagnostic testing within the National Health Service (NHS) mean many male fertility problems go undiagnosed.
One of the most common and treatable causes is varicocele—a dilated vein in the scrotum that raises testicular temperature and damages sperm. Surgical repair can often restore fertility, while lifestyle changes, such as improving diet, avoiding excessive heat, and limiting alcohol and tobacco use, may further improve outcomes.
Vaibhav Modgil, a urological surgeon and honorary clinical professor at the University of Manchester, said many men wait years for basic evaluations. By contrast, women are typically referred for comprehensive testing soon after reporting difficulty conceiving. “Most fertility services are led by gynecologists who focus primarily on women’s health,” Modgil said, noting that most regions have only one or two specialists in andrology, the male reproductive field.
The issue has gained renewed attention following the release of the U.K. government’s first Men’s Health Strategy. While the plan was praised for its scope, experts criticized it for excluding male infertility as a strategic priority, a focus included in Australia’s comparable program.
Michael Carroll, a reproductive health researcher at Manchester Metropolitan University, said overlooking male infertility not only delays effective treatment but also ignores its mental health effects. He noted that infertile men tend to have higher rates of depression and shorter life expectancy. “Historically, fertility has been viewed as a women’s issue,” Carroll said. “We need to normalize testing and education for men in the same way.”
Lifestyle habits are a major factor. Many men are unaware that tight clothing, hot baths, and poor sleep can harm sperm quality. Carroll urged broader public education so men understand how everyday choices affect reproductive health.
Raj Mathur, a consultant in reproductive medicine and former chair of the British Fertility Society, added that the science itself lags behind. “Male fertility research has been neglected,” he said. “We need more large-scale trials to identify accurate tests and effective treatments.”
Recent data illustrate the knowledge gap: a Fertility Action survey found that 81 percent of general practitioners had received no formal training in male fertility, and 97 percent could not reliably identify varicoceles on exam.
Men’s health advocates, including Tim Shand of Men’s Sexual and Reproductive Health Matters, argue that better assessment of men would not only improve outcomes but also reduce costs for the NHS by preventing premature use of IVF.
The Department of Health and Social Care acknowledged the gap, saying the new Men’s Health Strategy aims to build a foundation for addressing gender-specific health inequalities, including infertility. “For too long, men’s reproductive challenges have been under-recognized. This strategy is a starting point for progress,” the agency said in a statement.
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