Infertility Specialists Say Men Often Overlooked

M I D D L E T O W N, Conn., Aug. 3, 2004 -- Caroline Kilian is 3 years old and as graceful as a dancer. She loves to pick blueberries in the back yard.

She's the miracle child her parents thought they might never see.

Beth and John Kilian tried for more than a year to conceive and had no idea why they couldn't.

"Automatically, we considered me to be the primary issue," says Beth, who was 25 and working as a health-care program planner when they began.

Her doctor could find nothing wrong with her, but had her take Clomid, a powerful fertility medication, for several months. "Without a doubt, of course, it was just going to be me."

John, a 34-year-old software engineer, believed the same thing: "I think eventually the doctor did say, 'John, let's take a look at you,' but initially that was not what he was looking for."

The Kilians went through a form of torture that thousands of couples endure every year. About half of all infertility cases involve a problem with the husband's sperm — but that is rarely where doctors look first.

"I think that men in general get too little medical attention," says Dr. Larry I. Lipshultz, professor of urology at the Baylor College of Medicine in Houston. "The man is the second partner to be evaluated, rarely the first. And it's often at his wife's urging rather than his own volunteering."

Lipshultz says the problem is built into the modern health care system. When couples have trouble conceiving, they generally go to the one reproductive specialist they know — the wife's gynecologist.

Gynecologists do what they are trained to do: treat women. As a result, Lipshultz says, a woman may go through extensive testing and treatment. Half of the time, it is fruitless.

"It's going to take a much shorter period of time, less money, and certainly less discomfort, for the male to be evaluated," he says. "The woman's evaluation is usually painful and more time-consuming, so it's logical to get the man's evaluation out of the way."