The widespread availability of ICSI has led to a “coming out” of infertile men across the region. Governments have helped this process along by pushing to make fertility treatments more accessible through public financing. Today, Middle Eastern men are increasingly open about their fertility problems: They tell their families, share information with friends and colleagues, and swap clinical recommendations with others needing help.

Nabil, an infertile man in Beirut, explained this changing view to me during my 2003 study of male infertility in Lebanon: “People know it is a medical problem. So we don’t feel this problem of manhood or womanhood. In our company, four to five people have IVF babies. So, in my company, people talk about it. I tell everybody about it. I don’t mind. My boss said, ‘You’ve been married for more than two years and you didn’t get your wife pregnant yet?’ I said, ‘I’m trying,’ but I couldn’t get my wife pregnant yet.” Nabil’s boss was even sympathetic enough to give him paid time off to accompany his wife to the local university’s IVF clinic.

As men like Nabil have come to acknowledge their infertility problems and seek treatment, they have helped to lighten the heavy load once carried by their wives: the scrutiny from in-laws, the social ostracism, the threats of divorce or polygynous remarriage. Indeed, the introduction of high-tech male infertility treatment and Middle Eastern men’s eager embrace of this technology have had positive effects on gender relations across the region.

To be sure, there are very real and important differences between the Middle East and the West when it comes to male infertility. In the Middle East, most infertile couples are barred from using donor sperm to conceive, despite the religious permissibility of many other treatments and technologies such as ICSI. In the West, ICSI has long been widely available, but the cost sometimes makes it inaccessible, particularly in the United States. But the primary obstacle has come from men’s own silence on the subject — and here is where the Middle East can serve as an instructive example.

Studies in the West have shown that male infertility remains a hidden, highly stigmatized problem — laden with feelings of inadequacy, confused with impotence and often spoken of, derogatorily, as “shooting blanks.” If women in the West have made great progress in talking about their own fertility struggles, men’s progress in this arena has been much slower going. In the West, the psychological stigma might not wind up as a barrier to seeking treatment — most couples who want a child are by now open to medical intervention if they can afford it. But it does mean that many men will experience unnecessary psychological pain and isolation.

Although the Middle East is rarely held up as a model of progressive gender thinking, the region is a case study in the power of recasting infertility as a medical problem, not one of manhood. Technology can help, but in the end, there’s a large role for men themselves to play in speaking up about male infertility, especially as sperm counts fall.