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Having practiced medicine for almost three decades now, I’ve learned quite a few things. As one who always seeks to improve, the one thing that I would most like to change in our healthcare system is its “defensive” orientation. Medicine spends too much time reacting to health problems after they occur, like treating kidney stones and cancer. Medicine desperately needs to become more “preventative” in nature. In my view, identifying risk well before it becomes disease allows for disease prevention, and that my friends is the Holy Grail of medicine.
In the Box
People know this. That’s why they take $360 billion of nutritional supplements annually in the US alone. And maybe that’s why over 100 million individuals have mailed off their spit or blood for personal DNA testing since the technology was introduced 15 years ago. Many of us really want to know what might happen to us as we age. Along these lines, I’d like to propose another preventative measure: consider checking the fertility of young men before they consider family building.
Out of the Box
Why check young men’s fertility potential? Well, it can tell us a lot about their fertility potential and that may change how and when they approach family building. Equally importantly, a man’s fertility potential is now known to be a biomarker of his health. And not only his current health, but his future health.
What Does Being Infertile Mean for a Man?
The same lifestyle choices that make you healthy also keep you fertile. Here is a summary of the risk that being infertile brings to bear on a man’s health:
- 30% increased risk of cardiovascular disease
- 150-300% increased risk of cancer
- 120-1000% increased risk of chronic disease
- twofold increased risk of early mortality
How do I see this fertility check happening? Well, the lowest hanging fruit to grab would be to check a semen sample. Traditionally requiring a doctor’s order, my belief is that laboratory-certified semen analyses give better and more information than simpler over-the-counter sperm check kits. Luckily, high quality semen analyses can now be done from the comfort of your own abode through on-line, mail-in companies like Legacy. The best checkup would also involve a visit with a reproductive urologist for a good old-fashioned medical history and physical exam (it doesn’t hurt!) and an interpretation of the semen analysis, because the sperm count alone does not make or break the man. Bowing to the COVID pandemic, even a virtual visit or telehealth visit with a urologist would be better than no visit. And that’s it. Really.
I see the pre-fertility check for men as a neat way of instilling a little preventative care into the half of our species that for the better part of their lives, feels nothing if not immortal. As the old proverb goes, an ounce of prevention is worth a pound of cure.
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