Men's perceptions of long-term health outcomes following fertility problems: a UK-based mixed-methods survey

To explore men's assisted reproductive technology (ART) experiences, awareness and concerns about fertility-associated health outcomes, and perceptions of using administrative health records in the United Kingdom (UK) without consent to investigate these outcomes.

Over a 2-year period, all adult men were eligible to complete an anonymous online survey distributed via a UK-based fertility charity's social media. Free-text responses underwent thematic analysis, and categorical responses were analysed with descriptive statistics and Fisher's exact test.

Among 80 participants, most were aged ≥ 40 (66.7%), completed university (70.2%), White (77.2%), and UK residents (83.0%). Older (p = 0.004) and White (p = 0.001) men more likely underwent ART. Most ART users received treatment privately (60%) within the past three years (71.4%). Only one-fifth of the 15 men with identified fertility problems received discussion on fertility-associated health outcomes in clinic. Regarding perceptions, most were unaware of but concerned about these outcomes across biopsychosocial aspects, with participant quotes reflecting uncertainty and vulnerability. Recency of ART was associated with awareness (p = 0.015) and concerns (p = 0.001). Overall, 90.3% supported using administrative health records to investigate long-term health of fertility-challenged men, and 84.2% had no concerns about doing so without individual consent under established legal frameworks. Others raised concerns about the reliability of data anonymisation. Quotes suggested participants' desire to understand the wider health implications of male fertility amidst a perceived gender imbalance in fertility research.

Gaps in participant knowledge, clinician communication, and research in male fertility-associated outcomes support the need for universal education and further investigations in these outcomes.