Fertility, infertility and masculinities: An ethnographic study of men's reproductive health

This dissertation is an ethnographic study of the emergent and changing field of andrology, the biomedical specialty dealing with the evaluation and treatment of men's reproductive health. Participant-observation in a sperm bank, an andrology laboratory, and at an andrological clinic together with interviews with sperm donors and infertile patients are the richest contribution of this dissertation to the anthropology of reproduction. Using feminist theory and the anthropology of science the aims are: (1) to underline how the lack of standardization in the diagnosis of male fertility and infertility reveals constructions of masculinities; (2) to illuminate how the fragility and the vulnerability of men's fertility is overshadowed by a scientific and commercial coalition; (3) to document how at this particular moment in history men's reproductive and sexual health are increasingly subject to biomedical study and intervention. The most puzzling problem of this dissertation is the question of the very limited ability of fundamental andrology to define ‘what is a normal fertile sperm’ together with the stubborn adherence, despite contradictory scientific knowledge, to sperm counts as the most popular measure of men's ‘procreative power’. How can sperm donors be diagnosed fertile and patients be diagnosed infertile if sperm analysis, the basic andrology laboratory test, does not measure the fertilizing ability of spermatozoa? The paradox is illustrated in the standardization by WHO of quantitative data like sperm counts and the incapacity of scientists to establish a baseline to determine deviation. In studying the categories ‘men’ and ‘reproduction’ I was led to ‘men’ and ‘potency’ and, in a surprising twist—thanks to a commercial and scientific coalition—for the first time in the history of andrology, to norms and deviations from masculinity.