By: the Jack Fertility team
Health and Social Care Secretary Wes Streeting confered plans for a men’s health strategy at a Men’s Health Summit with Movember and the Premier League at the end of November 2024. The Government has said that the strategy will address the biggest issues affecting men of all ages that are costing lives, which could include heart disease and strokes, prostate cancer and testicular cancer, as well as mental health and suicide prevention, and will form a key part of the government’s 10 Year Health Plan to fix the NHS.
We at Jack Fertility were dismayed to see that male reproductive healthcare, a massively stigmatised issue that massively affects male mental health, and growing scientific evidence shows could be linked to prostate and testicular cancer, is not mentioned. As sperm count is down almost 60% globally in the last 50 years, and infertility affects 1 in 6 couples, it is vital that we include fertility and associated sperm related issues in a national men's health conversation.
We made our thoughts known in the call for feedback in the Change NHS: Help build a health service for the future portal. Rather than letting our recommendations simply sit in the portal and hope they are read, we decided to share them here, to engage in a dialogue with individuals and organisations similarly committed to optimisation of men's health and wellbeing.
Q1. What does your organisation want to see included in the 10-Year Health Plan and why?
The 10-Year Health Plan must address the systemic neglect of male fertility. Male reproductive healthcare needs to be reframed as a proactive and preventive healthcare matter, not a niche concern. Male fertility is more than a reproductive issue - it’s a public health challenge, an economic priority, and a societal necessity. Tackling it now is one of the simplest, most impactful changes the NHS can make to reduce costs, improve outcomes, and address glaring inequalities in healthcare access.
Currently, male infertility is treated reactively, often as an afterthought. Access to NHS semen analysis is restricted to narrow criteria - heterosexual couples trying to conceive naturally for over 12 months - and requires an in-person GP referral. Even then, results are often shared only if they are clinically abnormal, excluding men with suboptimal parameters that could still be improved. This outdated approach neglects the diversity of modern family planning and perpetuates stigma, limiting opportunities for early intervention and pushing too many couples toward invasive treatments like IVF.
The imbalance in male reproductive care is stark. On the NHS’s website, male fertility is relegated to brief mentions, primarily under “causes of infertility,” with little emphasis on actionable care beyond semen analysis and chlamydia testing. Similarly, the NICE guidelines for infertility treatment focus almost entirely on female factors, reinforcing a systemic neglect of men’s reproductive health. In contrast, the World Health Organization’s page on infertility addresses male and female issues equally.
This imbalance matters. Male infertility is equally as likely to contribute to fertility challenges as female factors, yet it is often underutilised in improving outcomes. Unlike female fertility, which can require invasive and time-intensive investigations, male fertility is dynamic and highly responsive to change. Sperm regenerates every three months and can improve significantly with relatively simple interventions such as lifestyle changes, dietary optimisation, and targeted treatment. These characteristics make male fertility an untapped opportunity for prevention and early intervention.
As Health Secretary Wes Streeting said:
“For too long, we’ve told men that talking about their health - let alone asking for help - is a sign of weakness. That needs to change.”
Male fertility exemplifies this stigma, with many men avoiding testing due to misplaced fears, embarrassment or societal pressures. Reframing male fertility as routine healthcare would break these taboos and engage men in meaningful, transformative ways, supporting broader health goals.
The perception that fertility is ‘not an urgent matter of life and death’ often relegates it to the bottom of NHS priorities. This view is short-sighted. Fertility challenges have profound effects on individuals’ quality of life, their hopes and ambitions, and societal well-being. These challenges influence population trends, mental health, and economic stability - all areas the NHS aims to address. Ignoring male fertility perpetuates inequity, increases emotional and financial burdens, and misallocates NHS resources.
Take one of our clients at Jack Fertility: after his partner experienced multiple miscarriages, he accessed our semen analysis in Oxford. The results revealed suboptimal motility and an asymptomatic infection, shared with his partner. With dietary changes, tailored supplements, and infection treatment, the couple conceived naturally and are now safely in their second trimester. This is the power of early intervention. A test, a conversation, and simple lifestyle changes avoided the need for costly, invasive treatments like IVF.
Yet today, many couples are steered toward IVF because male testing and intervention happen too late. IVF, while critical for some, is expensive (£5,000 per NHS cycle; £8,000-£10,000 privately), invasive, and emotionally draining. Many couples require multiple cycles, exacerbating debt, stress, and pressure on NHS resources. Male infertility is the leading reason for IVF in the UK, accounting for 37% of cases, according to the HFEA. Addressing male fertility earlier could prevent many of these cases, reducing the burden on families and the NHS.
Even modest improvements in early male fertility testing could have an outsized impact. Proactive measures reduce conception times, improve pregnancy health, and lead to healthier children. Emerging research links poor sperm health to genetic disorders, autism, and other complications. Average sperm counts have halved in the past 50 years, with widespread infertility projected by 2045 if trends continue.
The solution is simple: reframe male fertility as routine healthcare, break the stigma, and integrate low-cost, high-impact measures into NHS services. As Wes Streeting said, “Prevention is always better than cure.” Male fertility is a clear and urgent example of where this principle can transform lives.
Jack Fertility strongly supports the government’s men’s health strategy announced by the Health Secretary in November. This focus is a step in the right direction, and we urge the 10-Year Health Plan, as well as the Men’s Health Strategy, to include male fertility as a key pillar. Addressing the emerging crisis now will have profound, long-lasting benefits for individuals, families, and society.
Q2. What does your organisation see as the biggest challenges and enablers to moving more care from hospitals to communities?
Male fertility offers a clear use-case for improving access, normalising proactive healthcare for men, and relieving pressure on hospital services.
Challenges:
Stigma and masculinity: Male fertility is shrouded in stigma, often tied to harmful stereotypes about masculinity. Societal norms frame reproductive health as a “female issue” and link male fertility to notions of masculinity. This deters men from seeking care and engaging with their reproductive health.
Restrictive access: Current NHS criteria exclude many groups who would benefit from early intervention, such as younger men, single men, and non-heterosexual couples. These barriers are offputting, preventing timely testing and action.
Enablers:
Engaging younger men: Male fertility testing provides an opportunity to engage younger men - the demographic least likely to visit a GP - with broader health messaging.
Proactive policies: France’s proposal to offer free fertility screening for under-25s shows how routine testing can transform reproductive care by identifying issues before they escalate.
Leveraging existing campaigns: Public health initiatives, such as those around mental health, cancer screenings (e.g. Movember), and STI prevention, have primed men for health-focused conversations. Fertility could be seamlessly integrated into these efforts to drive engagement and awareness.
This isn’t about building new systems or expensive treatments - it’s about reframing how and where men access existing care. Normalising fertility testing in communities is an efficient way to address unmet needs, reduce stigma, and ensure timely interventions.
Q3. What does your organisation see as the biggest challenges and enablers to making better use of technology in health and care?
Technology offers an ideal solution to the often-overlooked area of male fertility care, providing scalable, discreet, and cost-effective solutions. However, its adoption comes with specific challenges unique to this field.
Challenges:
Lack of standardisation in fertility care: Unlike female reproductive health, male fertility lacks cohesive, standardised pathways for care. Digital solutions often highlight this fragmentation, making it difficult to integrate results like semen analysis with existing NHS services or create a seamless follow-up experience. This leaves men without clear next steps, even after testing.
Cultural stigma and engagement barriers: While at-home and tech-based solutions offer privacy, many men are unaware these options exist or dismiss fertility issues as “not their problem.” Without targeted messaging, technology risks reinforcing passivity rather than encouraging proactive engagement.
Siloed innovation: Many digital male fertility tools are developed in isolation by private companies, with limited efforts to link them to NHS services. This results in promising innovations operating outside the mainstream care system, excluding those reliant on public healthcare.
Enablers:
At-home solutions tailored for male fertility: Simple, discreet home-to-lab semen analysis kits lower the psychological and logistical barriers many men face when accessing fertility care. These kits allow men to test their fertility in their own time and space, normalising proactive engagement with their health.
Personalised, actionable insights: Technology can deliver more than just test results - it can provide men with tailored, step-by-step advice on improving sperm health. For example, apps or reports could include recommendations on lifestyle changes, dietary adjustments, or medical follow-ups, turning data into a clear action plan.
Targeted awareness campaigns through digital platforms: Tech-based fertility services offer an opportunity to engage men with messages that meet them where they already are - on their phones and online. Social media, apps, and digital campaigns could demystify male fertility and position testing as a normal and necessary step in overall health.
Integrated data-sharing systems: By connecting semen analysis results with electronic health records, the NHS could ensure that digital tools become part of a joined-up pathway, allowing for efficient follow-up, referrals, and treatment when necessary.
Leveraging NHS-private partnerships: The UK fertility industry is heavily privatised, with most treatments, including IVF, provided by private clinics regulated by the HFEA. This creates barriers for patients who cannot afford private care and limits the adoption of new technologies within NHS settings. Partnering with private providers to introduce promising and innovative tools, such as home-to-lab semen analysis kits, into NHS pathways offers a practical solution. These partnerships can help integrate accessible, cutting-edge approaches into public healthcare, ensuring more equitable access to fertility care while enabling the NHS to benefit from advancements already gaining traction in the private sector.
Technology in male fertility care is not just a convenience - it’s an essential tool to overcome stigma, improve access, and create actionable pathways for men. When thoughtfully integrated, it can shift the narrative around male fertility from silence and shame to empowerment and engagement.
Q4. What does your organisation see as the biggest challenges and enablers to spotting illnesses earlier and tackling the causes of ill health?
Male fertility testing is not just about reproduction - it provides a gateway to engaging men with their overall health and well-being.
Challenges:
Delayed care: Male fertility issues are typically addressed late, often after prolonged infertility. This delay limits opportunities for simple, effective solutions and increases emotional and financial strain.
Missed opportunities: Treatable conditions like varicoceles - which can often be resolved through quick, minor in-patient procedures - are frequently undiagnosed for years, leaving men with unresolved and preventable fertility issues.
Lack of education: Fertility education is grossly underdeveloped. A 2015 survey by Nuffield Health found that 50% of men would not discuss fertility concerns with their GP, and 1 in 3 were unaware that lifestyle factors like diet and exercise impact fertility. In schools, a single bullet point in statutory guidance mentions the impact of lifestyle on fertility, and a 2023 UCL study found that only 35% of English students rated their sex education as “good” or better. The resulting lack of awareness means many men fail to connect lifestyle factors, fertility health, and overall well-being.
Enablers:
Routine screening: Incorporating semen analysis into routine NHS health checks would allow early identification of issues and enable fast, cost-effective interventions.
Engaging men earlier: Fertility testing provides an entry point for engaging men with broader health challenges. Fertility health is closely linked to overall health, and addressing it can have far-reaching benefits.
Preventive metrics: NHS success should be measured by avoided Assisted Reproductive Technology (ART) cases, rather than only ART success rates. Realigning incentives this way would encourage proactive care. Furthermore, the majority of ART procedures are conducted in private clinics regulated by the HFEA, whose business models inherently incentivise treatment over prevention. The NHS can help provide a counterbalance that highlights holistic, early intervention.
Addressing male fertility earlier ensures that men not only access timely fertility care but also engage with their broader health needs, creating ripple effects for overall well-being.
Q5. Please use this box to share specific policy ideas for change.
Immediate actions (1 year):
Offer free and unrestricted semen analysis for men, inspired by France’s forward-thinking policy proposal on this. Normalising early testing would enable early detection of issues and help men make informed, actionable choices about their health and futures.
Raise public awareness of the global sperm count decline and the impact of lifestyle on fertility. Campaigns should emphasise that proactive lifestyle changes can improve sperm health in just 90 days, reducing conception times and improving pregnancy outcomes.
Mid-term changes (2-5 years):
Expand the availability of fertility screening to remove restrictive barriers and normalise testing. Emerging from-home technologies, such as home-to-lab test kits, could be leveraged for nationwide coverage to ensure equitable access and timely interventions.
Encourage and train healthcare professionals to provide holistic fertility care, addressing both lifestyle factors and treatable conditions like infections or varicoceles.
Integrate reproductive health into existing public health campaigns, particularly those addressing comorbidities such as hypertension, diabetes, and testicular cancer. Infertile men face higher risks for these conditions, making reproductive health an effective and early entry point for preventive care.
Long-term changes (5+ years):
Establish NHS male fertility clinics to ensure parity with female reproductive services. These clinics would provide dedicated, specialist care for men while addressing broader reproductive health needs.
Develop holistic male reproductive health services that incorporate advancements in urology and andrology alongside fertility care.
Invest in longitudinal research into male fertility trends. This would enable evidence-based planning for NHS resource allocation and ensure policies reflect changing societal and population needs.
Jack Fertility Ltd has been proud to participate in the Hill’s Accelerator Programme as part of the NHS Oxford Trust. As a private company offering home-to-lab sperm tests, we share the NHS’s mission to improve health and reduce inequalities. We are ready to collaborate and share our expertise to advance this vital agenda.
Any questions or feedback on this, please contact the team at media@jackfertility.co.uk
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