I don’t know if you caught Rhod Gilbert’s BBC documentary earlier this week: Stand Up to Infertility, but if not, you should. I heard him interviewed on Women’s Hour, and very entertaining he was too, but this was humour with a point: male infertility is a huge and growing problem.

And yes, it’s impossible to discuss it without launching into Finnbar Saunders’ style innuendos and double entendres, intentionally or not, and Rhod could win an award for just that.

But men don’t talk about their sperm issues, (or, as Rhod might say, tackle their tackle) and that’s not helping. Well, only a few do, like Rhod and the wonderful Benjamin Zephaniah who I heard discuss his own infertility struggles, on radio, several months ago, which was incredibly moving.

Even though just as many men suffer fertility problems as women.

Rhod makes a very good case. Number of registered gynaecologists & obstetricians in the UK? Over 8000. Number of andrologists? (A term most people haven’t heard of but which is the male reproductive specialist equivalent.) Fewer than 200.

Thankfully, there are now fertility forums a-plenty for women, who can share their journeys with others who are suffering the relentless rollercoaster that is IVF. But, despite this era of gender equality, and outing difficult topics that haven’t historically been shared, dodgy sperm doesn’t seem to have made it onto the agenda. Until now.

You may wonder why I have suddenly bridged from cheery tales about antibiotic resistance, inspired by my first novel, The Waiting Rooms, to infertility.

The reason is, that my next book, Off Target, tells the story of a couple who are both struggling with unexplained infertility. It’s another speculative thriller, set in a world where IVF and other treatments have become the norm.
And where would-be parents are confronted with an intimidating ‘shopping list’ of genetic reproduction services, promising them a healthy child. Sometimes, more.

Which is why I’ve had my head down researching this area for months.
It has been enlightening.

The fertility industry is, as Rhod says, mostly geared up for women, and a highly profitable industry it is, too. The global IVF market is projected to be worth $36 billion by 2026.
One in six couples struggles to conceive and it’s getting worse, driven partly by the fact we’re starting our families later, and also by other behavioural and environmental factors such as obesity, alcohol & drug consumption, sexually transmitted infections and stress.

What is amazing, given that infertility affects men and women equally, is the lack of treatment options for men. Once the basic behavioural improvements have been adopted (good diet, regular exercise, no toxins) and any infections dealt with, if matters still haven’t improved there are essentially just two options left: injecting sperm directly into the egg and/or extracting sperm from the testicles. If that doesn’t work, for the time being at least, you’re pretty much into donor sperm territory. Which is very tough, if you have your heart set on fathering your own biological child.

However, radical new fertility solutions are in development. This is the kind of territory I find rich for fiction: exploring how imminent science and tech will affect society and the everyday, and what choices it may force. And, believe me, there is a revolution coming in fertility treatments, or should I say assisted reproductive technology (ART): the smart new term for services like IVF, but bigger, with genetics on top. These new services may provide additional solutions for men and women, but they will raise challenging ethical dilemmas, too.

It’s early days for Off Target: I’m just about to submit my draft manuscript to my ever-patient publisher, Orenda Books, and embark on the necessary rounds of edits, but we are aiming for publication roughly this time next year.

On a more immediate and practical level, Rhod Gilbert has launched a website as part of his awareness campaign: himfertility, which has simple, accessible information on male infertility and how to get help.

I hope Rhod is able to take to the road again, post lockdown, and continue spreading the word. It’s a great initiative, and anything that can bring people together to talk about something so fundamental, so primal as the desire to have a child, and the heartbreak when it doesn’t go to plan, has to be the dog’s bollocks.

See what I did there? (Not a patch on Rhod: watch the documentary.)