Ben Goldacre, The Guardian, Saturday 25 September 2010

The Sun, of all people, are angry about pornography: “THE hard-up NHS is blowing taxpayers’ cash on PORN for sperm donors, a report reveals today.” The Telegraph immediately followed suit. Some clinics provide pornography for men masturbating in clinic rooms to produce sperm for IVF with their partners.

The report is called “Who said pornography was acceptable in the workplace” and is produced by a right-wing thinktank called 2020health. The author, previous conservative MP candidate Julia Manning, says pornography in this clinical setting is: a violation of the NHS constitution; a case of manipulation by the sex industry; the encouragement of “adultery of the mind”; a danger to men as it introduces addictive material into their treatment (which “beggars belief”); strips women of their human status; and is an abuse of taxpayers money.

The average spend on magazines was £21.32 per trust per year, with each clinic treating a large number of couples. For context, private clinics charge around £6,000 for each couple to have 3 cycles of IVF.

But the moral case may still stand: is the pornography necessary? Farmers, animal breeders and vets all have extensive experience of getting viable sperm out of male animals under artificial circumstances, and they have approached this very question, albeit tangentially.

Hemsworth and Galloway showed in 1979 that sperm count in the ejaculate of a domestic boar (I mean an actual boar, that’s not a euphemism for men) was significantly increased by allowing a “false mount”, or observation of another boar’s semen collection. I wouldn’t want to overstate the evidence: another study found that the effect seems not to be present in rams. But in 1984 Mader and collagues studied 12 Hereford Bulls and found that watching another mating pair in action significantly increased frequency of ejaculation. That very same year, Price and colleagues found semen collection from male dairy goats was faster with a “stimulus female”, which was present, but unmountable.

This can hardly be a surprise. As long ago as 1955, Kerruish reported that insemination centres for cows did not provide “adequate sexual stimulation” prior to semen collection: his regimen of intensive sexual stimulation resulted in a “marked improvement in sexual behaviour” and – crucially for our question – an increase in the conception rate.

But it gets more interesting. There is already evidence from animal research that males increase the amount of sperm in their ejaculate when there is more competition around. In 2005, Kilgallon and Simmons conducted an experiment to see whether human males viewing “images depicting sperm competition” also had a higher percentage of motile sperm in their ejaculates.

Now to my mind, this wasn’t a perfect study: they compared ejaculate in 52 heterosexual men looking at pornography with two men and one woman, against pornography with three women, whereas I think it would have been better to use comparison images with one man and one woman, but there you go. They found that men viewing the “two men one woman” pornography had a higher percentage of motile sperm. On a related note, Zbinden and colleagues found that male stickleback fish ejaculate more sperm after being shown a big rival than a small one.

But finally, bang on the question at hand, Yamamoto and colleagues in 2000 studied 19 men masturbating into a jar, either alone in a room, or with “sexually stimulating videotaped visual images” at hand. Sperm volume, total sperm count, sperm motility, and percentage of morphologically normal sperm were all higher when the men had pornography. Meanwhile, some men find it impossible to ejaculate on the day it’s most needed for IVF, and sperm can only be retrieved by epididymal aspiration, or rather, a needle inserted into the testicle. This is a seriously sub-optimal outcome.

I’m not saying porn is brilliant. I absolutely agree that the objectification of women’s bodies is a bad thing, and I don’t particularly want to see porn lying around at work, although by their very nature, you can see all kinds of dreadful things if you open the wrong door at the wrong time in a hospital.

All I’m saying is, when there is a reasonable evidence base that pornography helps people attain what for them are very important goals – like “not being childless” – when they’re going through the very strange and unpleasant experience of masturbating, alone in a clinic room, with everyone outside knowing what you’re doing, and quite possibly some kind of queue: then this research showing that pornography works is the sort of thing you might want to take into account, proportionately.