Gareth Down was just 21 when he was diagnosed with azoospermia: His semen was devoid of sperm. Following eight failed rounds of fertility treatment, he sought a community in which he could discuss his struggle. But all he found were groups that catered to female infertility, with little to no posts from men.
“I wasn’t comfortable talking about feelings on an open forum, so I thought a male-only group would give me the space to talk openly and get some help and advice,” Down said. So he did something about it.
Down launched Men’s Fertility Network, a Facebook group where men share the financial, physical, and emotional stresses of attempting to have a biological family. Members also review treatments, products, diets, and clinics–all with the mission to improve sperm quality. In the four years since its founding, the group has grown to more than 1,000 participants (and Down is now the proud father of a baby boy).
“Men need a safe place to talk,” says Down. “Men see male infertility as questioning their gender, and feeling less of a man if you can’t conceive naturally is a theme that’s often spoken about.”
One-third of all infertility cases are caused by male reproductive issues, and 30% of cases are a mix of the both male and female infertility, according to recent research. And yet women are often the target of family planning, clinics, forums, social campaigns, and health startups.
“But men have a biological clock, just like women,” notes Tom Smith, cofounder of Dadi, a male fertility startup that launched earlier this month. “And we believe that they should have the option to start a family when the time is right for them.”
Granted, fertility declines far more rapidly with age for women than for men. The National Institutes of Health reports that 9% of men and roughly 11% of women of reproductive age in the United States have experienced fertility problems.
Men are not exempt from the infertility crisis: A recent Hebrew University of Jerusalem study found that sperm counts among Western men declined by 52% in the last 40 years and is falling by an average of 1.4% a year. Those sobering stats have inspired a new generation of startups centered on sperm health, testing, and storage. They hope to accomplish something novel: getting more men to care.
A more convenient solution
After undergoing the process of freezing his sperm, healthcare consultant Khaled Kteily decided the industry needed an overhaul. He found masturbating in a small, dingy room to be “emasculating” and “awkward.” Besides, he thought, why even go to a clinic in a first place? Why couldn’t he do it from the privacy of his own bedroom?
In November, Kteily founded Legacy, which bills itself as the “Swiss bank for sperm freezing.” It focuses on the “consumer experience” of sperm collection, stresses Kteily, who now serves as Legacy’s CEO: “We wanted it to feel like a guy who is investing in his future, as opposed to being a very clinical kind of process.”
The service sends a discreet package to customers, who make a deposit at their convenience. The package keeps assets viable for up to 48 hours, in which time a shipping representative picks up the package for shipping to partner clinics. Specimens are frozen in two separate cities–“multi-geography storage” in the off-chance one gets destroyed in a natural disaster.
Thereafter, Legacy’s team of fertility and medical specialists send reader-friendly sperm analysis reports that explain the diagnosis, treatments, and lifestyle recommendations in layman’s terms, instead of incomprehensible medical jargon.
Packages start at $350 and go to $2,500 depending on storage preferences. While pricey, it’s a fraction of women’s fertility treatment costs: A single cycle of egg freezing runs $5,000 to $10,000, in addition to costly storage fees. Price point is one advantage the male sector has over its female counterparts.
But with most men unaware of male infertility issues or sperm health, awareness remains crucial for such startups to succeed.
That’s why education lies at the heart of Trak, launched in 2017 by Sandstone Diagnostics. The multi-pronged health startup sells a $74.99 sperm test and tracking kit, in addition to an app and popular standalone site: Dontcookyourballs.com informs men of reproductive health and actionable ways to improve their sperm quality.
The website approaches the topic in conversational, guy-to-guy talk with a dash of humor. The goal is to dispel the barriers of awkwardness that engulf the issue and get men to discuss fertility with partners. With no paid advertising, the site draws 300,000 unique views per month.
“Men come to us in the middle of the night in privacy mode on their cell phones looking for answers to these fertility problems,” explains Dr. Greg Sommer, chief scientific officer of Sandstone Diagnostics. The site’s message is clear: Male infertility is more common than you think, but there’s a lot you can do about it.
“Male fertility is not necessarily ‘fertile or infertile’; it’s kind of a sliding scale,” says Sommer. “When men adopt what we like to call sperm-friendly living, a few months can make a big difference.”
With fertility, early treatment is key in reversing or treating sperm quality. The average man trying to reproduce waits 12 to 18 months before men get tested, reports Sommer: “That’s a long time.”
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While at-home sperm testing is not a replacement for medical evaluation, it serves as a crucial first step. (Companies such as YO and SpermCheck also offer at-home tests.) Depending on a client’s diagnosis, the Trak team might suggest further testing or recommend local urologists from a checked database. “That initial, early assessment can make all the difference,” Sommer notes.
Sperm testing does more than just highlight reproductivity–it also detects greater biological markers. Numerous studies attest to sperm count as a biomarker for overall health. If a man has low sperm count, he has a higher likelihood of having or developing some other health condition. In many ways, Trak sees itself fulfilling a bigger need.
“We are reaching this young demographic of men that aren’t seeing a doctor, and fertility is really a strong motivator for these guys,” says Sommer. With the objective of better sperm, Trak advises men to stop smoking or eat more whole foods, among other directives. “It puts young men on the road to a healthier life.”
Like Trak, newly launched startup Dadi attempts to normalize the conversation, albeit with more psychological scare tactics. The at-home fertility test and sperm storage kit targets men in their mid-20s to early 30s who want to put off having a family, but not without handing them the hard truth first. Their tagline reads: “Store your sperm, stop the clock.”
“It’s important that we strike the right balance between having an approachable brand and message, but one that doesn’t sugarcoat the facts,” Dadi cofounder Tom Smith tells Fast Company. The website’s front page, for example, prominently declares that 1 in 10 American men are deemed infertile. “We’re very direct . . . Your sperm isn’t getting any younger.”
The $99 testing kit features all the trappings of millennial catnip: A bold, minimalist sculptural box disclosing an Amazon Echo Dot-like contraption inside. It’s like a Norwegian unboxing video.
Design seems to be of utmost importance to Smith, who says an outdated landscape and user experience inspired him to launch the company. He recalls frequenting sperm bank sites and being unable to locate basic information, like price. (Traditional sperm lab analysis can run a couple hundred dollars.)
Last month, the startup secured $2 million in venture capital funding.
“You need to make sure that you’re offering something for men to complete when they want, how they want, and where they want,” says Smith. “And that’s why the at-home experience is so important.”
A woman’s work?
Male fertility startups get more men to pay attention to a critical issue that affects both sexes. And yet the onus still very much rests with women. Trak’s customers are split between the sexes, with half of them females buying a kit for their partner. Legacy, meanwhile, focuses outreach efforts on women.
“Women are much more thoughtful, not just about fertility, but about healthcare in general,” says Kteily, “which is why many of them are actually driving the decision-making here.”
The Legacy founder notes that as more women consider freezing their eggs to postpone having kids, they consider the equivalent for their significant other. (For the first time, more women are having children in their 30s than in their 20s.) It takes the pressure off both and allows them to spend more time building careers. Women, however, still lead that conversation.
Still, even if pushed, making men tend to fertility sooner than later ultimately helps women in the long run, says Kteily. “We’re rebalancing the responsibility of the family planning where fertility will no longer just be a women’s issue.”
Legacy is currently in talks with healthcare clinics that focus on female fertility and exploring partnering with greater workplace benefit providers. (Down the line, the company might incorporate genetic analysis into its sperm analysis.)
“Sperm freezing will become a social norm,” predicts Kteily. He sees it expanding to men who work in high-risk fields (like firemen), those undergoing medical treatment, and even parents gifting it to sons entering college–a graduation gift of sorts. “It might take 10 years or so, but [it will be] the same way that egg freezing has become a social norm among women of a certain age and economic status.”
Through ice-breaking humor or stark stats, these founders are adamant on democratizing fertility and getting the word out to young men. They’re hopeful. “There’s bigger, better attention to male fertility,” says an optimistic Sommer. “People are talking about it more and more.”