An­drea Helten

In­ter­view with author Be­ne­dikt Schwan

Be­ne­dikt Schwan learns at the age of 41 that he is in­fer­tile. In­s­tead of drow­ning in his grief, he chooses a dif­fe­rent path. The jour­na­list be­gins to re­se­arch — about male fer­ti­lity, and about how so­ciety deals with a taboo sub­ject. He in­ter­views doc­tors and fellow suf­fe­rers around the world and, along the way, comes to terms with his own per­sonal ex­pe­ri­ence with the dia­gnosis. The re­sult is a book that takes an open and ho­nest ap­proach to the ra­ther hushed-up, yet es­sen­tial topic of male ste­ri­lity: “Oh­ne­kind”. We asked Be­ne­dikt Schwan some ques­tions and re­ceived clear an­s­wers.

Mr Schwan, first of all, thank you — for your open­ness and the cou­rage to ad­dress a taboo sub­ject in our so­ciety: Male ste­ri­lity.

“You’re wel­come — I wrote my book “Oh­ne­kind” for myself, so the cou­rage came na­tu­rally. I had this perhaps so­me­what crazy idea to write about my own suf­fe­ring and get it off my chest, but at the same time to help and so­mehow sup­port others af­fected who have not yet had a voice. There are so many out there. I hope I have suc­ceeded in that, at least in a little bit.”

On the very first page, you take us rea­ders with you to your sperm test ap­point­ment. You de­scribe your tre­at­ments lea­ding up to your own dia­gnosis of “in­fer­tile and un­able to con­ceive”. Throughout your journey you share your own and your wife’s per­sonal thoughts, with all the doubts and fears that in­fer­ti­lity brings with it. To what extent was the wri­ting pro­cess a ca­tharsis for you?

 

“I be­lieve that the pro­blems will pro­bably never go away, they are con­stantly pre­sent in the back of my mind. In the be­gin­ning, I was faced with the ques­tion of what I ac­tually had in the first place, what was going on with my body and why I of all people was af­fected ? I wanted — also be­cause I am a jour­na­list and cu­rio­sity is part of my job — to find out as much as pos­sible about in­fer­ti­lity. I thought that that would help me re­ceive help so­mehow. At the same time, I was able to push the topic away from myself and “pro­fes­sio­na­lise” the way I dealt with it. That re­duced the pain a little. So I would say that wri­ting was a ca­thartic pro­cess. I learned a lot about myself and others af­fected in the pro­cess.”

“Azoo­spermia is your dia­gnosis and you de­scribe how you ap­proach the term in “Oh­ne­kind”. You re­se­ar­ched in fo­rums and self-help groups — and found out that men ra­rely talk openly about it. Why do you think male in­fer­ti­lity is such a taboo sub­ject for men?”

Photo credits: Nat Urazmetova

“I still wonder about that. I think it’s be­cause it goes to the core of mas­cu­linity. There’s a fee­ling of not func­tio­ning pro­perly, of not being able to fulfil their job given to them by na­ture. Buil­ding a house, plan­ting a tree, fa­the­ring a child.… It takes it out of you when you can’t do one thing. Many also wonder what women think of them now. Do they still take me se­riously? All of this is very painful. That’s why people prefer to sup­press it. More and more men are af­fected, and there is no need to be as­hamed of it, be­cause in the ra­rest of cases there is not­hing you can do about it!

Some people con­fuse in­fer­ti­lity with im­po­tence, but they have not­hing to do with each other. Azoo­spermia, as in my case, simply means that there are no sperm cells in the eja­cu­late that could fer­ti­lise an egg cell in the woman. Sex is com­ple­tely normal and the se­minal fluid also looks the same.”

But in fact, ac­cording to studies,male ste­ri­lity ri­sing in our so­ciety. Why is this so?

 

“Since the se­ven­ties, the sperm con­cen­tra­tion in the eja­cu­late of men in wes­tern in­dus­tria­lised coun­tries is said to have roughly halved. That doesn’t mean that they are all in­ca­pable of pro­crea­tion, but of course it doesn’t make pro­crea­tion any ea­sier. Ac­cord­ingly, there are more and more pro­blems to con­ceive children and the fer­ti­lity cen­tres are full. They say that in at least half of the cases, the man is in­volved and at fault if fer­ti­li­sa­tion does not occur.”

 

There is a lot of re­se­arch on the re­a­sons for this, but the field is un­for­tu­n­a­tely still to­tally ne­glected. Ac­cord­ingly, there are only as­sump­tions — the che­mical re­vo­lu­tion, for ex­ample, the many plastics, some of which have an ef­fect on hor­mones, from stress in so­ciety to the  mo­bile phone ra­dia­tion, which could both have an in­flu­ence. But we don’t re­ally know. What sur­prised me most was how acute and wi­despread the pro­blem is. This is what en­cou­raged me to write about the topic it and get in­volved — and it also makes rea­ders feel a little less alone.”

 

For “Oh­ne­kind” you go beyond the per­sonal level. You in­ter­view fellow suf­fe­rers, a Mormon fun­da­men­ta­list in Ca­nada with 150 children and you vi­sited sci­en­tists around the world con­tem­pla­ting what other coun­tries like Norway do better than us. Why was it im­portant for you to take such a broad view of the reproduction/family issue?

“In my per­sonal history, being a fa­ther was so­me­thing I put off for a very long time. My wife and I were in our mid-30s when we se­riously tried to be­come par­ents. I then asked myself why we put it off for so long and why so many other people do the same.

Why do so many seem to be so afraid of ha­ving children? What are we so­cially doing wrong, why are we end­an­ge­ring the fu­ture of our com­mu­nity by doing this, be­cause wi­thout children we can’t go on? Then there was the ques­tion of the image of fa­thers, which has changed a lot in re­cent years. And I just wanted to see what I could learn from others about the sub­ject.

In ad­di­tion, there were the sci­en­tific and me­dical aspects of male in­fer­ti­lity, which I simply wanted to un­der­stand. I also ex­pe­ri­mented a bit on myself, for ex­ample with a sperm self-tes­ting-kit.”

You im­pres­si­vely de­scribe how women get the short end of the stick when it comes to sym­ptoms and stu­dies in ge­neral me­di­cine. In con­trast, however, the sci­ence of re­pro­duc­tive me­di­cine is al­most ex­clu­si­vely fo­cused on women. Su­rely early dia­gnosis in men would be de­si­rable. What needs to change here?

“It’s a very strange story. Whe­ther it’s cancer, heart at­tacks or in­tes­tinal di­se­ases — for years me­di­cine as­sumed the man as the stan­dard model. In re­pro­duc­tive me­di­cine and fer­ti­lity tre­at­ment, on the other hand, we focus al­most ex­clu­si­vely on women, who have to go through all the in­va­sive pro­ce­dures, the harsh hor­mone tre­at­ment and much more. Men often don’t get their sperm tested until it’s long too late. Since there is no longer com­pul­sory mi­li­tary ser­vice, no one re­gu­larly looks at their pri­vates any more, the last in­spec­tion was usually done by the pa­ediatri­cian, so pos­sible di­se­ases are not de­tected. I think that on the one hand men don’t like to go to the doctor, on the other hand there is simply more fi­nan­cial re­sources wi­thin the wo­mens re­pro­duc­tive me­di­cine. For­give me if I’m a little cy­nical. Cou­ples who go through it re­ally don’t have it easy.”

Photo credits: Nat Urazmetova

What can po­li­tics do to en­sure the long-term exis­tence of our spe­cies?

 

“It should first re­co­gnise the pro­blem as a pro­blem. The lea­ding par­ties have now started to de­cide to put more money back into re­pro­duc­tive me­di­cine, to fund more re­se­arch. In 2003, po­li­ti­cians de­cided to fi­nance three fer­ti­lity cy­cles but still then only half. Since then, people have gone into debt in the tens of thousands. In my opi­nion, this is com­ple­tely in­sane. The state should do ever­ything to make it ea­sier for people to have children. That starts with the me­dical side, but it doesn’t end with fa­mily-friendly em­ployers, well-func­tio­ning day-care cen­tres and a ge­neral appre­cia­tion of par­ents.

 

Un­for­tu­n­a­tely, im­mi­gra­tion alone is not en­ough to main­tain our com­mu­nity, espe­cially since we are “ste­aling” people from other coun­tries. Cur­r­ently, we still talk a lot about over­po­pu­la­tion. I pre­dict that this will change soon, be­cause in­fer­ti­lity is be­co­ming more of  a pro­blem world­wide.”

From today’s per­spec­tive, what ad­vice would you give to men who still wish to have children? When do you think men should ad­dress the issue of fer­ti­lity and the de­sire to have children?

“As early as pos­sible. I ad­vo­cate that a sperm test should be done at the onset of pu­berty. Just as women have their gynae­co­lo­gist, we need a “men’s doctor” for men. Par­ents should pay ex­plicit at­ten­tion to the issue of in­fer­ti­lity in their sons. There are in­fer­ti­lity di­se­ases like Klinefelter’s syn­drome, where so­me­thing can still be saved if it is de­tected in time. But we are not at all doing anything re­gar­ding the topic, men only come to the doctor when they have the acute pro­blem. There is no pre­ven­tion!

 

 

I also think it is im­portant that it is so­cially ac­cepted that men want to have children of their own ac­cord. They don’t just come to it when their wife’s bio­lo­gical clock is ti­cking. Ha­ving a child is ing­rained in al­most all of us, whe­ther male, fe­male, trans or non-bi­nary. That’s why the loss through in­fer­ti­lity is so hard.”

In “Oh­ne­kind” you share with us your thoughts about ha­ving an M‑TESE done in order to start a fa­mily after all. In the end, however, you de­cide against it. Hand on heart: Did you re­gret not ha­ving had your sperm tested ear­lier and frozen if ne­cessary?

 

“We de­cided against it mainly be­cause we were too old. I didn’t want to put my wife through this in­credibly hard pro­cess of fer­ti­lity tre­at­ments in her for­ties, espe­cially since the chances also de­crease greatly with age. So quite ho­nestly: I ex­tre­mely re­g­retted not ha­ving dealt with the issue ear­lier.

I still don’t know why I am un­able to pro­create. I am the­re­fore trying to help re­se­arch and I am part of a gene panel that is loo­king for mar­kers of in­fer­ti­lity. So far, there has been no hint here. No­body knows when I be­came in­fer­tile, whe­ther it is con­ge­nital or came later. And this is the case for al­most all those af­fected! Ac­cord­ingly, I would urge all young men to look into the issue. Have a sperm test con­ducted as soon as pos­sible, then you will know! Even if you don’t want to have children yet. That will come soon en­ough!”

About Be­ne­dikt Schwan:

Be­ne­dikt Schwan has been a jour­na­list for over 20 years, spe­cia­li­sing in tech­no­logy, sci­ence and re­se­arch. His texts have ap­peared in “Zeit On­line”, “Focus” and “Spiegel On­line”, among others. Schwan is mar­ried and lives in Berlin. “Oh­ne­kind” is his first book and was pu­blished by heyne Verlag in 2020.

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