Authors’ reply to Titley

We thank Titley for his comments and regret if our paper created the impression that infertility does not have a profound impact on men.12 We agree that infertility affects both men and women biologically, psychologically, sociologically, and as part of a couple. We avoided gender terminology in our paper where we could, referring instead to individuals and couples. We also agree that more research on men’s infertility is needed.It is not time, however, to stop recognising that infertility affects many women disproportionately, especially but not only in low and middle income countries. While local differences exist in the nature and degree of this disproportion, its existence is not an assumption but a reality based on extensive medical and social scientific literature from across the globe. Only when this evidence is replaced by new and better evidence that refutes current knowledge will the moment come to consider the impact of infertility…
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