In the period before conception, family health history and current health behaviors matter for women and men alike, say the researchers, adding that more clinical research needs to be done on how men's bodily health affects their sperm, and in turn, reproductive health outcomes.
"The lack of attention to men in research on reproduction leaves open many important questions, including how men's reproductive contributions are understood," say the researchers.
The vast majority of medical and social science research on reproduction focuses on women. It wasn't until recently that scientists began studying the role that men's behavior and men's health play in reproductive outcomes, such as fetal health, birth defects, and childhood diseases.
The stereotypical association of women with family and men with work has led to a focus on women's bodies in reproduction, leaving the question of how men's health contributes to reproduction unanswered
"What kinds of advice, if any, do men receive about preparing their bodies for reproduction?" ask the researchers. "Men should be empowered with information about how their age, health history, and unhealthy behaviors can affect pregnancy outcomes."
The sperm bank is one of the few places where men's reproductive health takes center stage, the researchers note. At sperm banks, men are counseled on healthy eating, avoiding stress, and reducing alcohol consumption. Not adhering to this advice can and does lead to lower sperm counts, suggesting that this kind of guidance might be more broadly useful for men trying to conceive children with their partners.
There are also associated policy implications. The Affordable Care Act stipulates that women with private insurance are no longer required to pay for pre-conception health appointments, but excluding men from such coverage continues to obscure their role in reproduction, say Almeling and Waggoner. "Paying attention to how reproductive equations influence policy can suggest new and different avenues for improving public health," say the sociologists. They add "Recent public health initiatives devoted to preconception care offer at least the possibility that men's reproductive contributions will be considered alongside women's."
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