Based on a conversation between Francesca Steyn (Malebox Health), Lois Whelan (Braetha Clinic) and Ashley, a Braetha patient
Most of what's written about IVF is aimed at the person having the injections and scans. Far less covers how to support your partner through IVF when you're the one sitting next to them, or what treatment is like from that chair.
Lois Whelan, a fertility nurse consultant at Braetha, sat down with Francesca (Fran) Steyn, Head of Clinical Services, Quality and Governance at Malebox, and Ashley, a Braetha patient who has spent almost five years in fertility treatment with his wife. Ashley was clear from the start that he sees himself as the narrator and his wife as the real hero. Fran told him he was a hero too.
Partners have often been an afterthought
When Lois started in fertility, clinics called patients in by the woman's name only. The male partner came into the room for the pregnancy scan and not much else.
Fran remembers something more recent. During COVID, partners weren't allowed into scan rooms at all. "If you are having treatment together, whether you're using your sperm or not, you're a couple having treatment and you should both be included," she said. "You're both the patients. That's how I see it."
Men who've been through treatment describe that feeling of being left out. In a survey of men with fertility problems by Fertility Network UK and Leeds Beckett University, 93% said their wellbeing had been affected, and many felt the support before, during and after treatment was aimed at women (Pavilion Health Today, 2017). We've written about this gap before in Why Are We Still Overlooking the 50%?
Ashley's story: five years and two clinics
Ashley and his wife both had tough starts in life. They decided early on that they wanted things in place before having children, so their kids would get a better start than they did. That meant careers and a house first, and some time to see the world. They started trying in their early 30s, just after COVID.
"I just assumed that it would just happen naturally," he said.
When it didn't, they went to the NHS fairly quickly. Ashley is clear that NHS staff do jobs he couldn't do, but he feels the fertility care they received was slow to investigate. Without a diagnosis they were told to keep waiting. "You're essentially just burning time." It took close to four years from first trying to finding a private clinic he felt was properly looking after them.
Since then: five egg collections, one cancelled collection, three embryo transfers that didn't work, and a long run of tests for both of them. They now have nine embryos stored and are moving on to transfers.
IVF isn't a backstop
The thing Ashley most wants people to hear is about time. He and his wife treated IVF as a safety net. If it didn't happen naturally, there was always IVF. He now calls that "a false backstop".
"Everything gets better except for fertility," he said. Between your 20s and your 30s, your job, your money and your home usually improve. Fertility goes the other way. "I always got told there's no right time to have a child. But what I've learned is there is a time that you can't have a child."
He'd have liked more proactive testing: an AMH blood test for women in their mid 20s, and a semen analysis for men, which he found "surprisingly easy" next to what his wife has been through. His mum had suggested tests years before. "If we had known, things would have been different and we would have made different choices."
Lois sees the same gap in clinic. School teaches you how not to get pregnant, she said, and nothing about what to do if you have a problem. "Our bodies are still like cavemen and women." Testing earlier might not change the outcome, and you might still choose to wait, but you'd be choosing with the information in front of you. There's more on that in Male Fertility Testing Before Trying for a Baby.
How to support your partner through IVF: Ashley's advice
Lois asked Ashley what he'd tell a man at the start of treatment.
Ask if you can be there when your partner comes round
At one clinic, Ashley wasn't allowed to be with his wife as she came round after egg collection. He was told to go and wait in the car.
"It sounds really, really small," he said, but he called it "such a horrendous experience" and now uses it as a test for any clinic. "Ask whether or not you can be by the bedside of your partner when they're coming around after an egg collection. If you cannot be there, don't use that clinic."
Clinics differ on this, so it's worth asking at your first appointment.
Put it first
"When it comes to fertility, that is the priority," Ashley said. For him that means being at every scan, whatever's going on at work. On clinic days he's up early and does the chores so his wife doesn't have to think about them.
Take on a job
Ashley admits he isn't great with appointments, so his wife runs those. He took the injections instead. He has the wipes ready, knows how to mix the drugs, checks the doses, and cheers her on when the needle bounces off her skin for the second time.
Lois mentioned another couple where the man had been put in charge of every appointment and kept them all in his phone. A job like that means you're part of it rather than watching.
Make the bits around the appointment better
On clinic days they're often up at half five for the trip into London. They always stop for a coffee and a pastry first. Afterwards Ashley walks with his wife back towards the tube so they can talk about how it went, and if it hasn't gone well, he makes the time to stay with her.
He links this to the peak-end rule, the idea from psychology that people mostly remember the most intense moment of an experience and how it ended. Nothing makes a scan nice, but the coffee before and the walk after are things he can do something about.
Learn the language
Things improved once they started learning everything they could about the process, partly by using AI tools to understand terms and results. "It's your job to make sure that you fight for yourself and you understand," Ashley said. "The faster you do that, the less pain that you'll go through."
Fran agreed you have to advocate for yourself, with a caution. AI tools tend to be reassuring, and she sees patients given a false sense of reassurance about results that need reading alongside both partners' medical history. "Use it, but with caution." We go into this in When AI Reads Your Results: Why a Specialist Matters.
Say you're in it together
Ashley told his wife early on: "We chose to wait. So we'll both see this out regardless of the outcome."
Partners need support too
Ashley describes his role as providing and protecting, and says that in IVF the protecting is emotional rather than physical. Lois has seen men expected to act a certain way during treatment, though she says that's slowly changing as partners get more involved.
Fran shared a story from Ciaran Hannington, who co-runs The Male Fertility Hub. Through several rounds of treatment and a miscarriage, nobody asked how he was. Then, after a scan showed no heartbeat, a nurse turned to him and asked how he was feeling. He said he crumbled.
"Sometimes I think that's all you need," Fran said. Her ask of nurses, doctors and GPs is to direct the question at the man as well as the woman.
Counselling
NICE says people having problems conceiving should be offered counselling before, during and after investigation and treatment (NICE QS73). Partners can ask for it too. Fran says every fertility clinic should have access to a fertility counsellor, and you don't need something to be wrong to use one.
Lois points out that the counsellor sits outside your treatment. Nothing you say to them affects it. "Everyone would benefit from knowing their own brain a little bit better."
Peer support
The Male Fertility Hub, run by Shaun Greenaway and Ciaran Hannington, has thousands of men in its groups, and it isn't only for men with a male factor diagnosis. Plenty are there to talk about supporting a partner. Fertility Network UK also runs a male-focused online support group. Shaun tells his own story in Male Fertility and Mental Health.
Talking about it
Ashley and his wife kept it to themselves for a few years. When word reached his granddad, who got in touch to say he was sorry, Ashley's first reaction was that he'd rather have controlled who knew. But talking made things "a little bit lighter", and he started to see how many people were going through the same thing. He now talks about it with his barber.
Lois has seen this in her own life. After one of their miscarriages, her husband went back to a very male workplace and was asked if he was feeling better. He told them he hadn't been off sick, they'd had a miscarriage. Several men in the room said it had happened to them too. None of them had ever mentioned it.
Ashley's one request of friends and family: never ask 'why don't you just adopt?' Ask that, he says, and "you have become public enemy number one."
What this means in practice
If you're the partner, a few things from this conversation are worth doing early.
- At your first appointment, ask about your role in treatment, including whether you can be in recovery after egg collection.
- Ask your clinic about counselling for you, not only for your partner.
- If you haven't had your own fertility checked, do it now. Fertility problems can affect either partner (NHS), and the NHS advises seeing a GP after a year of trying, or sooner if the woman is 36 or over.
Fran's small change for everyone else is about language. Stop treating it as a specialist subject, and stop splitting it into male factor and female factor. "It's fertility." She still sees couples where the woman says the problem is hers, to protect her partner.
Frequently Asked Questions
How can I support my partner through IVF?
Go to as many appointments and scans as you can, and take on practical jobs such as managing appointments or preparing injections. Ask whether you can be with your partner as they come round after egg collection. Make time to talk before and after appointments, and look after your own wellbeing as well.
Can partners stay with you after egg collection?
It depends on the clinic. Some let partners stay in recovery, while others ask them to wait elsewhere. If it matters to you, ask about it before you start treatment. Ashley, who has been through five egg collections, says he would now choose a clinic based on the answer.
Is there emotional support for men going through IVF?
Yes. NICE says people having problems conceiving should be offered counselling before, during and after treatment, and partners can ask for it too. Peer groups such as The Male Fertility Hub and Fertility Network UK's male support group let men talk to others who have been through the same thing.
Should men have a fertility test before IVF?
Fertility problems can affect either partner, so both should be investigated. A semen analysis is a standard part of fertility investigations. Testing early, before months or years of trying, means anything relevant is picked up sooner and you can make decisions about timing and treatment with the full picture.
What should you not say to someone going through IVF?
Ashley's advice is to never ask 'why don't you just adopt?' It brushes aside what the couple is going through. A simpler approach is to ask how they're doing, and to ask the partner too, since they are often left out. Listening usually helps more than advice.
Thanks to Ashley for being so open, and to Lois and the team at Braetha. If you'd like to check your own side early, that's what the Malebox at-home sperm test is for.
The full recording can be watched here.
Francesca Steyn is an NMC-registered fertility practitioner with over 20 years in reproductive health. She has served on the NICE guideline committee and the HFEA legislative reform group.
Lois Whelan is an Advanced Nurse Practitioner and Fertility Nurse Consultant at Braetha Health, Harley Street.
