When it comes to infertility, the proverbial history books—whether about Ancient Egypt, the Roman Empire, or Victorian England—tell a consistent story: Women have always shouldered the blame.
Famed wife-swapper Henry VIII pointed the finger at his first two wives for their multiple late-term miscarriages, stillbirths, or neonatal mortalities. Not long after, in Spain, Charles II’s first and second wives were forced into fertility treatments before each was deemed infertile, despite the King’s own well-documented poor health. The list goes on, with high-status men repeatedly being let off the hook for their inability to impregnate women. And whenever any couple couldn’t conceive, pretty much every culture assumed it was because the woman (and the woman alone) was “barren.”
That narrative persists today. Even though we now know that male factors like the volume, speed, or shape of sperm contribute to infertility in couples struggling to conceive about 50 percent of the time, if a heterosexual couple struggles to get pregnant, it’s typically the woman who’s subjected to a multitude of tests long before the focus shifts to her male partner.
So when historian Jennifer Evans, PhD, a professor at the University of Hertfordshire and author of Men’s Sexual Health in Early Modern England, first started noticing written descriptions of not just female but male infertility in historical sources, she was shocked.
The Infertility Trap
In diaries, medical notes, family recipe books, and personal letters, Evans saw descriptions of infertility posed as a problem for both genders.
There’s the 15th-century recipe to correct sterility in men. A 12th-century medical document that claims a failure of a man’s “seed” is a “defect of heat” and a manuscript from the 14th century with instructions on how men get their wives pregnant through pseudo-magical rites. “When sterility happens between married people, the males are accused by many people of not having suitable seed,” John of Mirfield wrote in a treatise of medicine compiled somewhere around 1390.
In fact, if you look closely enough, texts from as far back as ancient Egypt suggest that for literally thousands of years, people not only suspected that male reproductive disorders existed, they’ve been trying to find ways to treat them. At one point, men were advised to drink dried ground pig testicles sprinkled over wine, or consume boiled catnip on an empty stomach. To test which partner was infertile, our ancestors once asked a couple to each urinate into a pot of grains. After 10 days, the presence of maggots in one or the other would determine who was to blame. (If this sounds like a kind of foolishness you’d only see in the past, keep in mind that when traditional routes of medicine fail, it’s estimated that nearly 30 percent of couples will reach for alternative methods, some of which border on the medieval.)
Evans says these “cures” were often directed at male partners. And even when they weren’t, many took a conspicuously coed approach. “Certain examples of fertility remedies were nominally to make the woman conceive,” Evans said. “But they’re applied to the male body. And so you have to wonder: Are they treating the woman or the man? Or both together so that they don’t have to talk about the potential problem with a male body?”
In the 1400s, an Italian husband and wife wrote dozens of letters to friends, family, and business partners openly discussing their frustration at not conceiving. More than two hundred years later, in 1664, famous diarist Samuel Pepys drunkenly bemoaned his years of trying to conceive, asking the crowd present for advice on how to get his wife pregnant. Nine out of 10 tips involved actions he should take—e.g., wearing cool undergarments, drinking sage and other herbal teas, keeping his stomach warm and his back cool, along with sexual techniques and tips. The subtext? Pepys (known for his sexual dalliances), and not his wife, was blamed for their childlessness.
Evans was surprised to learn that men of centuries past were sometimes described by medics as “imperfect,” producing “cold,” “thin,” or “unfruitful” seed, because even today it’s rare to talk openly about male infertility. “One of the things that prompted me to write my book in the first place was the amount of men I knew in my life who kept something hidden for a long time before they’d sought help,” Evans said.
According to Evans, despite the actual facts, historians ignored the evidence of male infertility for the same reason we ignore it today: the assumption that masculinity equals virility and the fear that being infertile makes someone less of a man.
“Impotence—the inability of a man to perform sexually—was bound into notions of masculinity and what it means to be a fully grown adult man,” Evans said. Pamphlets ridiculing men as cuckolds whose wives left them unsatisfied were common in the 17th and 18th centuries.
Today, influencers fret over their testosterone levels and advocate semen retention (not ejaculating because they falsely believe it increases energy and vitality). The pro-natalist movement has cheered as some of the world’s wealthiest men father obscene numbers of children. Though data from an exclusive Cosmopolitan survey around infertility shows that 69 percent of men and women know that fertility is the responsibility of both partners, for many men, masculinity and fertility are still inextricably linked.
But though Evans’ research suggests that attitudes regarding fertility have always carried a mixture of shame, confusion, and grief, it also demonstrates that acceptance—for our bodies and ability to conceive children—is nothing new. It’s hard not to look at the past and think that if individuals were capable of freely sharing their struggles half a millennium ago, we have an even better shot at an honest conversation today, when research has shown that semen volume and motility continuously decrease with age and fathering children older could increase the risk of miscarriage.
If we recognize that the male factor in infertility has always been known and openly discussed, we might finally be able to accept it.
