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Men with fertility problems are at increased risk of future health problems, this PhD will examine their psychosocial and clinical support needs

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  • Full or part time
    Dr L Ashley
    Prof G Jones
    Prof B Gough
    Prof A Pacey
  • Application Deadline
    No more applications being accepted
  • Funded PhD Project (Students Worldwide)
    Funded PhD Project (Students Worldwide)

Project Description

Men with fertility problems are at increased risk of future health problems including cancer. This PhD will examine awareness of this risk among men with fertility problems and fertility health care professionals, and both groups’ views, needs and preferences regarding the potential development and provision of psychosocial, clinical surveillance and health promotion information, support and services.

Supervision team:


Director of Studies: Dr Laura Ashley https://www.leedsbeckett.ac.uk/staff/dr-laura-ashley/
Co-supervisor: Professor Georgina Jones https://www.leedsbeckett.ac.uk/staff/professor-georgina-jones/ Advisor: Professor Brendan Gough https://www.leedsbeckett.ac.uk/staff/professor-brendan-gough/ Advisor: Professor Allan Pacey https://www.sheffield.ac.uk/oncology-metabolism/staff/pacey; http://mhs.group.shef.ac.uk/members/allan-pacey/

Start date


SMP studentship: February 2020 or defer to October 2020
GTA post: February 2020

Contact


If you are interested in applying for this PhD please contact Dr Laura Ashley for an informal chat and further information [Email Address Removed]

Research project: background and methods


Around 1 in 7 couples have difficulty conceiving, and for approximately half of these couples this is due wholly or partly to male factor problems (e.g. low sperm count, poor sperm motility) [1,2]. In recent years, a growing number of studies have shown that male infertility is a risk factor for future health problems, even after controlling for confounding variables such as socio-demographic and lifestyle factors. Several studies have found that men with infertility diagnoses are at significantly increased risk of later testicular and prostate cancers [3-8]. A 2016 population-based USA study found that men with oligozoospermia had a greater than ten-fold increase in the risk of testicular cancer relative to fertile men [5], and a 2019 population-based Swedish cohort study found that men who achieved fatherhood through ICSI (a form of IVF) had a 60% higher risk of prostate cancer compared with men who conceived naturally [7]. Research shows that male infertility is also associated with increased risk of other types of cancer, other health problems such as diabetes and heart disease, and a higher mortality rate [8-14]. Thus, although the aetiological mechanisms underlying infertility and subsequent morbidity are yet to be understood, mounting research highlights men with fertility problems as an at-risk group.

Consequently, some academics and clinicians are beginning to consider the need for increased counselling, clinical surveillance and/or health promotion for men with fertility problems [7,10,15-18]. For example, following their recent cohort study, Al-Jebari et al. concluded that men with fertility problems “constitute a risk group in which testing and careful long-term follow-up for prostate cancer may be beneficial” [7]; and Professor Allan Pacey commented in BBC news coverage of the cohort study that "perhaps all men who are diagnosed with a fertility problem in their 20s and 30s should be given a leaflet explaining what this might mean for them in their 50s and 60s, so that they can be aware of possible future problems, and be encouraged to visit their GP a bit quicker than they often do" [15].

Very little is currently known about the extent to which men with fertility problems, and fertility and other health care professionals, are aware of the growing evidence of male infertility as a harbinger of future health [17,18], and about both groups’ views, needs and preferences in relation to the potential development and provision of psychosocial, clinical surveillance and health promotion information, support and services. It is important to note that the psychosocial toll of infertility, assisted reproductive treatments and unwanted childlessness is well-documented [19-23], and thus the increased risk of future illnesses for men with fertility problems is something of a ‘double-blow’ for them and their partners – “it’s in the back of my mind, and then when I hear stuff in the news about being more likely to get cancer, and other things, it does worry me…especially now we have children, and after everything we’ve been through to have them” [35 year-old man who achieved fatherhood via ICSI]. Research into the experiences and perspectives of this at-risk group and their clinical teams is vital to ensure that any information, support and services developed and offered are acceptable and useful to men with fertility problems, and clinically appropriate and feasible.

This PhD will comprise: (1) a review of relevant literature (scoping or systematic review, depending on its exact focus, and the extent and nature of the relevant research [e.g. 21,24]); (2) semi-structured qualitative interviews with men diagnosed with fertility problems and fertility health care professionals; and (3) a quantitative survey(s) of a larger number of men and/or fertility professionals. The precise research questions and methods will be determined following the findings of the literature review, and through discussions with patient and public involvement (PPI) representatives and the supervision team.

Funding Notes

You can apply to undertake this PhD in the Psychology Department at Leeds Beckett University, fully-funded via either a Scientific-Medical Psychology (SMP) studentship or a Graduate Teaching Assistant (GTA) post. The SMP studentship is 3-years and the GTA post 4-years as it incorporates a teaching contract alongside a PhD studentship. Applicants must indicate whether they want to be considered for a SMP studentship, a GTA post, or both.

Apply here: https://www.leedsbeckett.ac.uk/the-graduate-school/research-degrees-at-leeds-beckett/studentships/social-sciences-studentships/

The deadline for all applications is 18th November 2019.
Interviews will take place week commencing 2nd December 2019.

References

1. http://www.nhs.uk/conditions/Infertility/pages/introduction.aspx
2. https://fertilitynetworkuk.org/fertility-faqs/male-fertility/
3. Hotaling JM, Walsh TJ. Male infertility: a risk factor for testicular cancer. Nature Reviews Urology. 2009;6:550-6.
4. Peng X, Zeng X, Peng S, Deng D, Zhang J. The association risk of male subfertility and testicular cancer: a systematic review. PLoS One. 2009;4:e5591.
5. Hanson HA, Anderson RE, Aston KI, Carrell DT, Smith KR, Hotaling JM. Subfertility increases risk of testicular cancer: evidence from population-based semen samples. Fertility and Sterility. 2016;105:322-8.e1.
6. Walsh TJ, Schembri M, Turek PJ, Chan JM, Carroll PR, Smith JF, Eisenberg ML, Van Den Eeden SK, Croughan MS. Increased risk of high-grade prostate cancer among infertile men. Cancer. 2010;116:2140-7.
7. Al-Jebari Y, Elenkov A, Wirestrand E, Schütz I, Giwercman A, Lundberg Giwercman Y. Risk of prostate cancer for men fathering through assisted reproduction: nationwide population based register study. BMJ. 2019;366:I5214.
8. Eisenberg ML, Li S, Brooks JD, Cullen MR, Baker LC. Increased risk of cancer in infertile men: analysis of U.S. claims data. The Journal of Urology. 2015;193:1596-601.
9. Eisenberg ML, Li S, Cullen MR, Baker LC. Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data. Fertility and Sterility. 2016;105:629-36.
10. Kasman AM, Li S, Luke B, Sutcliffe AG, Pacey AA, Eisenberg ML. Male infertility and future cardiometabolic health: does the association vary by sociodemographic factors? Urology. In press.
11. Latif T, Kold Jensen T, Mehlsen J, Holmboe SA, Brinth L, Pors K, Skouby SO, Jørgensen N, Lindahl-Jacobsen R. Semen quality as a predictor of subsequent morbidity: a Danish cohort study of 4,712 men with long-term follow-up. American Journal of Epidemiology. 2017;186:910-7.
12. Glazer CH, Tøttenborg SS, Giwercman A, Bräuner EV, Eisenberg ML, Vassard D, Magyari M, Pinborg A, Schmidt L, Bonde JP. Male factor infertility and risk of multiple sclerosis: a register-based cohort study. Multiple Sclerosis Journal. 2018;24:1835-42.
13. Jensen TK, Jacobsen R, Christensen K, Nielsen NC, Bostofte E. Good semen quality and life expectancy: a cohort study of 43,277 men. American Journal of Epidemiology. 2009;170:559-65.
14. Eisenberg ML, Li S, Behr B, Cullen MR, Galusha D, Lamb DJ, Lipshultz LI. Semen quality, infertility and mortality in the USA. Human Reproduction. 2014;29:1567-74.
15. https://www.bbc.co.uk/news/health-49808911
16. Keihani S, Hanson B, Hotaling JM. Male factor infertility: an opportunity to investigate individual and family health. BJOG; 2019:126:149-51.
17. Daumler D, Chan P, Lo KC, Takefman J, Zelkowitz P. Men's knowledge of their own fertility: a population-based survey examining the awareness of factors that are associated with male infertility. Human Reproduction. 2016;31:2781-90.
18. De Jonge C, Barratt CLR. The present crisis in male reproductive health: an urgent need for a political, social, and research roadmap. Andrology. 2019;7:762-8.
19. Greil AL, Slauson-Blevins K, McQuillan J. The experience of infertility: a review of recent literature. Sociology of Health and Illness. 2010;32:140-62.
20. Klemetti R, Raitanen J, Sihvo S, Saarni S, Koponen P. Infertility, mental disorders and well-being - a nationwide survey. Acta Obstetricia et Gynecologica Scandinavica. 2010;89:677-82.
21. Jones GL, Hall JM, Balen AH, Ledger WL. Health-related quality of life measurement in women with polycystic ovary syndrome: a systematic review. Human Reproduction Update. 2008;14:15-25.
22. Hanna E, Gough B. Men’s accounts of infertility within their intimate partner relationships: an analysis of online forum discussions. Journal of Reproductive and Infant Psychology. 2017;35:150-8.
23. Hanna E, Gough B. Emoting infertility online: a qualitative analysis of men’s forum posts. Health. 2016;20:363-82.
24. Price ML, Surr CA, Gough B, Ashley L. Experiences and support needs of informal caregivers of people with multimorbidity: a scoping literature review. Psychology and Health. In press.



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