'There's a stigma around male fertility': Why Chris Hughes and his brother want us to talk balls
When Chris Hughes had a testicle exam on live TV, he didn't imagine it would save his brother from cancer. Now the pair are on a mission to highlight male fertility.
Almost half the population have them, but are they looking after them properly and do they know how they work?
That's a question that former Love Island contestant Chris Hughes has been increasingly asking himself over the past few years, after having his own testicle troubles.
Chris, 27, and his brother Ben, 28, appear in a new BBC Three documentary Me, My Brother and Our Balls, to investigate the health of their own testicles, and hopefully inspire others to do the same. It's a personal journey for the Cotswolds siblings.
"I've had about four operations on my testicles, and the first time I discovered something wasn't right was when I was about 15 – I had a varicocele, which is a build up of veins on my left testicle," explains Chris.
"It didn't cause me much discomfort so I didn't do anything for a few years, I put it to the back of my mind. Then a few years later I had it sorted out, as well as an operation on a hydrocele (a build-up of fluid) on my right testicle."
In 2018, Chris had a live testicle examination on This Morning, which he says he wasn't fazed by because of all the procedures he'd had on his testicles in the past. But he couldn't have predicted the impact it would have had on his brother.
"I didn't even know he was going on This Morning to do the live examination," Ben says. "I came home from work and mum and dad told me I needed to watch it because my brother's done something pretty amazing.
"He came walking through the door at about one o'clock in the morning and I congratulated him and said it's going to help so many people, not realising it was going to help me."
That night, prompted by Chris's exam, Ben decided to feel his own testicles – and discovered a lump.
"It was almost like fate that Chris went and did it then I found a lump.
"I'd never thought about it before, you don't see too much about [testicular health] on social media or TV, and it was really strange how it happened.
"It felt like someone was looking down over us with Chris doing that."
After a few scans, it was confirmed the lump was cancerous but before he had it removed Ben decided to bank some of his sperm in case it was needed to conceive in the future.
That's when he was dealt another blow.
"My testosterone levels were far too low to produce any sperm," he says. "I got sent to London to see some other doctors and they put me on a course of medication about two months after my operation."
Ever since the removal of the cancer in January 2019, Ben has been on a journey to try and discover the cause of his fertility problem – and recover it.
He and his girlfriend Olivia aren't actively trying to have children yet but it's something they want in the future.
In the documentary, the pair cry after an appointment where Ben finds out his sperm count is almost non-existent. But despite the uncertainty, he's trying to stay positive.
"I think I'm in a better position than most of my friends who've never checked their fertility, and I think myself quite lucky that I'm in that position where I've already started having mine looked at and something's being done about it," he says.
If there's one thing Chris and Ben want men to take from the programme, it's to be aware of their own fertility, even if it isn't a current concern.
Studies have indicated that male fertility in Europe and the US is decreasing, with one finding an increase in fertility patients with a low sperm count of between 0 and 15 million.
In the early 2000s, nine percent of patients had such low quantities of sperm, but that's risen to 11.5% in the period between 2014-17. Another study found a decrease in average sperm count between 1973 and 2011.
Anything below 15 million sperm per millilitre of semen is considered low.
As to what's causing the decline, there isn't a definitive answer.
In the documentary, Chris quizzes some friends in the pub about things they think can affect sperm, and their assumptions are accurate – temperature, drug use and too-tight underwear can all be factors.
Researchers have also suggested other lifestyle factors like pollution could impact sperm health.
While Chris's sperm count was found to be healthy, Ben is on testosterone medication to try to increase his. One thing the brothers agree on is that we all need to open up about what's going on in our pants.
"We went down the local pub and all started discussing it, my mates and I realised how little we know and how little we're educated on male fertility," Chris says.
He and Ben feel that, as well as simply not being aware of how male fertility works, men can also shy away from talking about it because of societal pressures and ideas about masculinity.
"We obviously have sex education, but I feel like if we discuss fertility slightly, men and women would be more open about it.
"I feel like men can find it a bit demoralising, it's a bit of a masculinity issue.
"Men can feel guilty if they can't get a woman pregnant but it's as much of their issue as it is a female issue."
"Growing up, when Chris and I were younger and going out with our friends, we were trying not to get anyone pregnant but we didn't even know if we could!" Ben chuckles.
"It's a really strange situation to be put in, but I do think young lads should have their fertility looked at. That's what I advise all of my guy friends to do, even if they're not thinking about it, to get checked out and see what's what."
Chris adds that even a simple Google search about fertility topics results in lots of information for women, but less for men.
"Even the internet is stigmatising male fertility," he jokes. "We don't go down the pub and talk about this, but women might. It's a 50/50 issue."
"I've done a couple of talks to the sixth formers at my old school on how they can go about checking and if they find a lump, what they need to do about getting it checked out," Ben continues.
"I've tried helping as many people as I can and what we put on social media has a huge impact because we've had guys all across the world texting us saying what we're doing is amazing – they found a lump and they're getting it checked.
"A week later it comes back that it's a cancerous cell and they need to have chemo but they thank us for helping. I've had a lot of those sorts of messages and I know Chris has as well."
The first step to looking after your fertility, says Ben, is to be open - as difficult as that can be.
"I think men bottle up a little bit from talking about their feelings and how they are, because it's made out that men shouldn't have problems and they should be strong and get through them, which is really not true," he says.
"If there's one thing I'd like to say to men, it's just 'talk about it.'"
Find out more about male fertility from the NHS here.