Infertility in the media: semen analysis
I am a very passionate person to everyone who has met me. If you keep me posted on a topic that interests me, it can be difficult to slow me down at times. One topic I can talk about endlessly is the portrayal of infertility in the media. I get incredibly excited when I see how it’s portrayed – and I start throwing things on my TV screen when I see an inaccurate representation. As we are a urological practice, I thought I would focus on semen analysis first. Semen analysis and male infertility in general seem to have limited coverage even in movies and shows that feature infertility (Private Life, which came out in 2018 and is at the top of any list of infertility films, completely skips these I’ve got a lot about personal life to say, and it will appear many times in this series.
My favorite example of the worst portrayal of semen analysis and male infertility yet is in Dad is at home (2015). Brad (Will Ferrell) is portrayed as sterile after injuring his testicles. Dusty (Mark Wahlberg), the ex-husband, introduces the couple to a friend of his as fertility specialists, and Brad has a semen analysis and physical exam done. First of all, I don’t think infertility is a part of comedy. Ever. This comedy in particular shows a macho attitude dynamic between the characters. Men and women suffering from infertility often struggle with feelings about their “masculinity” and “femininity” and feel less male or less female because their body does not do what it considers the role and responsibility of theirs Define gender. Such a signal, putting the cool, dangerous, fertile, bad boy against the cute and nerdy, sterile man, promotes this unconscious message. (They double up when they reveal that Brad’s sperm has returned, stating that it is in response to his territory being threatened by a more masculine man.) That being said, their portrayal of the process is grossly inaccurate. I think it goes without saying that no reputable doctor would invite an irrelevant third party for a consultation without the patient’s consent, especially a pants-free consultation. Her big joke is comparing Dusty’s sperm production to Brad’s, where Dusty picks the big cup to break his own record. That was the line that made me turn to my husband in the cinema and whisper, “Dusty has syphilis”. While that’s probably not true, I thought my joke was funnier than yours. The punchline – and the truth? More sperm has nothing to do with more sperm. Sperm is a method of fluid delivery produced by the prostate and seminal vesicles – a completely separate process from sperm production. While low semen volume can be linked to poor sperm production, abnormally high semen volume can sometimes indicate infection-related prostate inflammation (not necessarily an STI). A normal semen volume is 2-6 ml, which is in the ball park of a teaspoon.
Now let’s talk about a couple of shows that went a little better. This is us (I love this show) presents Toby (Chris Sullivan) and Kate (Chrissy Metz) with a myriad of fertility-related challenges (spoilers ahead) such as pregnancy loss, IVF, preterm birth, and post-abortion infertility. Season 3 Episode 1: Nine Bucks hits the Toby side of that coin where he discovers he has a low sperm count with low motility and her doctor suggests that this is related to his use of antidepressants. This connection is being investigated and I think it was an appropriate inclusion. However – and unfortunately this is often the reality in real life – the sperm factor got a minute of doctor’s time. A couple with male infertility may benefit from having the male partner subjected to additional tests to understand the underlying cause – especially before the blame is placed on the antidepressant. Toby, feeling tremendous pressure to do his part for the success of his IVF cycle, stops his cold turkey on antidepressants and experiences emotional effects as a result. It’s good to see this relatable experience portrayed to suggest to men that this is a bad idea. It’s a shame the fertility specialist didn’t encourage Toby to speak to his psychiatrist about alternatives to drugs or the ability to safely and slowly get off his medication. And when neither is a healthy and safe option to support and encourage Toby to continue on his medication regimen and what impact this may or may not have on fertility treatment. So, bottom line? An overall encouragingly accurate representation showing male infertility could, however, have done more in the area of male fertility assessment and emotional support.
Brothers & Sisters Season 1 Episode 6: For the kids, Tommy (Balthazar Getty) and Julia (Sarah Jane Morris) reveal that they have been trying to have a child for a while. Tommy asks for a semen analysis during a routine checkup and is informed that he is sterile. I want to correct the recording. Tommy appears to be azoospermic with no semen in the semen sample (See what Maze would recommend Tommy as the next step). That is a few steps from the conclusion that Tommy is unable to have biological children. Tommy would benefit from seeing a urologist and learning about his options. This was a disappointing one-liner fertility diagnosis that allowed the show to move on to the topic they really wanted to talk about: sperm donors. (We’ll come back to this topic in the future.)
My oldest and most popular portrayal of infertility will always be in Friends, more because it’s just a show you can’t really get mad at than because they did something special. By the late ’90s, they were quite advanced across the board at portraying the nontraditional family dynamics through a single parent, pregnancy carrier, and adoption. And contrary to what I said earlier about comedy as the wrong medium for infertility, I think Chandler (Matthew Perry) was the perfect character to wear male infertility. In Season 9, Episode 21: The one with the fertility test, he’s uncomfortable and uncomfortable while waiting for his semen analysis, so you say, “Yeah, me too, brother.” (Although they use the same inaccurate joke about the size of the sample cup When they receive the results of infertility from male and female factors, they are told that biological ancestry is unlikely to happen to them. I can’t say enough about what fertility treatment options were actually available to them at the time, as I was around 10 years old when this episode aired. Tangentially, I’ve never heard of an “inhospitable uterine environment” used in an actual medical setting – only in Friends and Grey’s Anatomy – and it kind of reminds me of feminine vapors, a term that could mean almost anything and nothing specific at the same time . While there may have been room to further refine the story, overall it has been a very reliable account of the real-world experience of infertility tests and emotional outcomes.
For more information, see this series, Infertility in the Media! In the meantime, if you are having infertility issues, contact us for a free phone consultation to learn more about your options.