Episode 81: Men’s Health and Male Fertility with Dr Bola Grace

In this episode, Dr Bahijja Raimi-Abraham discusses male fertility and what men think about reproductive health with Dr Bola Grace, a senior executive with over a decade of leadership experience in the Biotech Industry.

Photo of reproductive technologies by Reproductive Health Supplies Coalition. Notice anything about them — all of them are designed for women!

Dr Bahijja: Could you tell us a bit about yourself?

Dr Grace: So, my name is Bala Grace and have worked in the healthcare industry for over 15 years, providing clinical instruction to multidisciplinary teams. I have worked in med tech, women’s health, digital health, and now a lot of work around inclusive inovation. My PhD was in public health and epidemiology, which led to a lot of my current work via my connections. I also recently just completed an executive MBA.

Dr Bahijja: Could you tell us a little bit about your research?

Dr Grace: In terms of my research, I started my journey more interested in HIV and finding a cure for HIV. That is what initially got me interested in biology and is what led me into diagnostics initially. I wanted to do more than make products and I wanted to make more connections, which is what led me more into industry and eventually to my MBA. I was originally looking more into women’s health, however, as policy and research regarding women’s health inevitably will touch on men’s health, I also started looking more into the subject of men and male fetility. […]

Dr Bahijja: Was your PhD full-time or part time?

Dr Grace: I actually completed it part-time, while I was working. I had a full-time job and I was leading a team, while doing the PhD part-time. It definitely helped a lot in my multi-tasking skills and I also ended up doing by MBA part-time while I was working.

Image of baby by Omar Lopez.

Dr Bahijja: There is often an assumption that fertility issues occur exclusively in women, and there is an issue of advocacy related to men’s infertility. What led you to men’s health and these sorts of topics, and what kind of challenges have you experienced?

Dr Grace: Our research wanted to understand the level of engagement of men in reproductive health and fertility discussions. This was coming from a public health perspective, and we know that globally the discussion of men’s health is essential. We also know that studies on reproductive health, disproportionately focus on women. To some extent the number of studies completed on women is perfectly fine — considering the reproductive health burden, however, there is a definite neglect of these issues when it comes to men’s health. For example, when a person is having difficulty getting pregnant, the automatic assumption is usually that the issue is the woman, and not sperm counts, etc.

We have also looked into some of the factors associated with men’s fertility in our study, such as quality of life and age related fertility decline. In literature, there are mnay hypotheses that have been proposed regarding the lack of men in these dicussions — but they were just that, hypotheses. So we decided to actually look into it ourselves. […]

Dr Bahijja: I noticed your recent paper “You Did Not Turn Up — I Didn’t Realise I Was Invited” regarding the inclusion of men in discussions related to fertility, could you talk a bit about it?

Dr Grace: It really summed up the study perfectly. Something really insightful from the study was that many of the men who participated were very interested, but noted that a lot of the general lack of interest was because health professionals, educators, and clinicians had not made it clear enough that men were also invited into fertility discussions. They made it clear that men really are actually interested in this topic, but because it is presented as generally a women’s health issue, they try to stay out of it to stay respectful. The title was actually a direct quote from a participant “I didn't realise I was invited” in reference to discussions of reproductive health and fertility. […]

Dr Bahijja: Generally, how much of the global burden of reproductive and fertility issues is faced by men and how much by women?

Dr Grace: Current scientific opinion suggests it is around 40% men, 40% women and 20% unknown or uncertain affiliation — so fairly equal. Regardless however, the perception of the importance of women within childbirth and fertility really lends to people assuming it is generally a women’s issue, but its pretty equally split.

Dr Bahijja: Is there any information around whether gender of health professionals might affect how comfortable a patient is discussing fertility (ie. men might be more comfortable talking with other men)?

Dr Grace: Absolutely, that was one of the key findings from our research study. When it comes to recommendations and best practices, we are really fighting for gender equality as it (fertility) is one of the few areas where men are really unrepresented. One of the quotes from the study was particularly insightful into how male patients feel about this — “if I had a man telling me what to do and how to take care of my fertility, I would feel more inclined to listen, than if it were a female doctor”.

Dr Bahijja: On that subject, is there an issue of funding in relation to men’s fertility?

Dr Grace: Before people get into funding, I think we really need to increase the level of interest in the subject. Once more professionals are interested, more patients get involved, etc. [then more people will be interested studying the subject and will apply for funding]. So first we need to recognise the problem, then get more people involved, and then at that point get the funding and start recruiting men for research into men’s fertility issues. Currently, most men invovled in these studies already have experience with fertility clinics, so moving forward it would be better to have studies involving the more average men (who might be less informed on the subject).

Image by Jonathan Sanchez.

Dr Bahijja: What exactly would the engagement of men entail?

Dr Grace: I really want to reiterate that people need to be empowered to make decisions about their reproductive health, whether it be single men or women, or couples with fertility issues. The engagement, from a public health perspective, at the moment is typically from heterosexual couples trying to have a baby — but overall, the balance is still tipped towards women being more heavily involved. The reasons, from research, we have seen this comes from school education, general societal perspectives, and other viewpoints that lend towards people thinking of fertility as solely a women’s issue. […]

Dr Bahijja: What are you doing currently in relation to men’s fertility and your research?

Dr Grace: Currently, we are incorporating the findings of our research into awareness campaigns. We have campaigns locally, in our institute, we have fertility education initiatives, we present our research at conferences, and we have worked really hard to advocate for the inclusion of men within fertility discussions.

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Monday Science | Weekly Podcast

Monday Science | Weekly Podcast

An engaging podcast bringing you the latest research in Science, Technology and Health.Hosted by award winning scientist Dr Bahijja Raimi-Abraham.