Pornography in hospitals

September 25th, 2010 by Ben Goldacre Tags:
in bad science, politics | 67 Comments »

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.

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67 Responses

  1. nanite2000 said,

    September 27, 2010 at 8:56 pm

    @Sili (#41): By that rationality, a lot more money can be saved by simply cutting out funding for cancer research and treatment. If you want to limit population growth, then you might as well cut out those people who are least likely to survive, right?

  2. Daibhid C said,

    September 27, 2010 at 10:54 pm

    Am I the only one here who remembers the episode of Coupling with the fertility clinic? Steve goes into a rant about the poor quality of porn available, and dragoons Jeff into, yes, getting his personal stash for him…

    @Steve August (#40): I’d be absolutely astounded if the Sun doesn’t have nude pictures on the walls, given that it has them in the paper. The only way this could be more hypocritical is if it was the Star

  3. andy2 said,

    September 28, 2010 at 2:05 am

    Funny you should speak about The Star as they have already covered the same report and reported on it in the most attention seeking manner by advertising their owner’s porn channel! It was duly picked up by tabloid watch….

  4. MSB said,

    September 28, 2010 at 9:49 am

    @ 0tralala, thank you. You put it far more eloquently than I ever could.

    One thing that got me though was the poor collection method. Surely a condom would help with trapping the collection. The Pope wouldn’t approve, though.

  5. bob sterman said,

    September 28, 2010 at 10:17 am

    Indeed copulatory ejaculates collected using a special condom are superior…

    Zavos PM. Seminal parameters of ejaculates collected from oligospermic and normospermic patients via masturbation and at intercourse with the use of a Silastic seminal fluid collection device. Fertil Steril1985;44:5 17-20.

    Zavos PM. Characteristics of human ejaculates collected via masturbation and a new silastic seminal fluid collection device. Fertil Steril 1985;43:491-2.

  6. Moobs said,

    September 28, 2010 at 11:14 pm

    When I opened the drawer in the little Pine table in St Thomas’IVF unit’s sample collection room, I was greeted by a copy of Farmer’s Weekly. Gracing its cover was an enormous udder.

    I was offered the chance to watch DVD Porn on condition I filled in a questionnaire that indicated whether it had made the process more “efficient”. The form did not elucidate how efficiency was to be measured.

  7. elvisionary said,

    September 29, 2010 at 11:50 am

    Not a pleasant experience. When I went into the little room I was surprised to find a dog-eared copy of Razzle in a drawer. The whole environment was hardly erotic, and it was soon evident that the editor of Razzle and I didn’t share the same view of what is attractive – I think the naked female form is an incredibly beautiful thing if presented in the right way, but this was all a bit gynaecological and disrespectful for my tastes.

    So I returned Razzle to the drawer and tried to focus my mind on the task in hand. Not surprisingly, I had a little difficulty finding the required, ahem, fortitude. But my brave little soldiers dutifully lined themselves up and on my command launched themselves out of the trenches and charged into the no-man’s-land of the little tube. Unfortunately it was only at this point that the aforementioned fortitude fully arrived, and because I had positioned myself in such a way as to ensure no wastage, I soon found myself painfully stuck. Not recommended.

    All in all, I’m totally in favour of such material being provided to those who find it helpful, no matter how tasteless it might be. Anything to help people get a tricky job done…

  8. The_Purple_Cow said,

    September 29, 2010 at 3:04 pm

    My experience was at the Vrij Universiteit Hospital in Amsterdam in late 1998, and early 1999. I think I must have been there for five or six ‘donations’, before I finally came up with enough goods to produce my two sons.

    The cubicles were in a block of six, which were segregated only by thin sheets of pegboard, through which you could hear everything down to the softest rustle in the other cubicles. I noticed pretty early on that white guys tended to go in alone, but Turkish and Moroccan guys tended to take their partners in with them. It was grimly fascinating to hear couples getting it on in Turkish or Arabic just a couple of feet from where I was sitting. The cubicles were painted grey with a hard bench covered in paper roll. Other than that there was an ancient TV with a VHS player, a pile of ten to fifteen year old porno magazines, a porno video cassette, a box of tissues and a waste basket with a lining marked ‘Biological Materials’. You couldn’t really open the magazines, the pages were ‘glued’ together with years of spilt semen, I tried pealing a couple of pages apart, but gave up pretty quickly.

    All the cubicles had the same movie, it starred a nice looking Dutch girl wearing early ’80’s disco clothing (remember those bright blue lycra leggings and the pink headbands?), even on a trip to the supermarket. Much of the movie was filmed on an Amsterdam house boat about two hundred meters from where I lived, (the boat is still there). At one stage she emerges on to the deck, having shagged three blokes senseless, and you could see the end of my street behind her. Incredibly, by pausing the video I was able to ascertain that our neighbor hadn’t changed her curtains in at least fifteen years. Unfortunately I more often than not got stuck in cubicle four, where the video was stuck on a boring scene where she sat with four blokes in a restaurant. I’m sure that scene lead to something, but unfortunately I’ll never know.

    On the last fateful day, I sat very early on a cold grey Monday morning under a fluorescent strip light that continuously flickered on-and-off and made a loud buzzing noise. I’d just thought, ‘let’s just get this done and get out of here’ when I heard two electricians explaining to the receptionist that they had come to replace the strip light in cubicle 4! So there I am doing what I have to do, while there’s a big hairy-assed Dutch bloke hammering on the door, shouting “hallo-oh, is there anybody in here? ‘ere Jan, are you sure it’s cubicle four?”

    My humiliation was complete, but maybe that’s what did the trick…?

  9. NeilHoskins said,

    September 30, 2010 at 4:11 pm

    Nice article, Ben, thank you. And thanks also to 0tralala and the others who describe the whole miserable experience far better than I could myself, having been there, done that, and got the t-shirt. IVF is an unpleasant, nasty experience and its details aren’t discussed openly nearly enough. I should add, of course, that the unpleasantness, nastiness, and humiliation are about ten times worse for the woman.

  10. squitchtweak said,

    September 30, 2010 at 10:49 pm

    A slightly more serious comment on Statgen’s comment about the tea and biscuit – how much money does the NHS spend on tea and biscuits? They do seem to like giving people tea.

  11. LastResort33 said,

    October 1, 2010 at 1:56 pm

    @squitchtweak: Tea is a very important part of the healing process… considering how difficult it is for anything to happen in the NHS, a cup of tea while you wait is vital.

    And I’m not joking either, the placebo effect shows that making people feel better is about more than drugs and surgery. It would be interesting to see some sort of trial done to compare the recovery rates of people consistently being offered tea against those not.

  12. misterjohn said,

    October 1, 2010 at 9:06 pm

    I had lithotripsy treatment for kidney stones last week, and was offered tea (or coffee) and biscuits afterwards. My wife was also given a cup of tea. But no sandwich as it was too late.
    The coffee and biscuits were very nice, particularly as I was drugged up to the eye balls with pethidine, and hadn’t eaten or drunk anything for 8 hours.
    I guess the NHS must spend a lot on tea and biscuits, but they probably have a placebo effect or better. The Government will no doubt soon expect you to bring in your own biscuits and tea bags, as an economy drive.

  13. gothgirl said,

    October 3, 2010 at 4:46 pm

    Surely what one needs is a copy of the Sun with its famous ‘nature’ photography on page 3. Objectifying women? But who am I to accuse the Sun of hypocrisy.

  14. Guy said,

    October 4, 2010 at 8:26 am

    Purple cow. that was brilliant. thanks for sharing the reality. Perhaps we should start a campaign for better quality porn for the poor donors! When you think of the billions spent in hospital, a few quid on magazines is neither here nor there. Typical red top hypocrisy.

  15. LiseW said,

    October 6, 2010 at 10:15 am

    Do you think the NHS would mind much if the men (and possibly women) brought their own pornography with? 🙂

  16. ml66uk said,

    October 21, 2010 at 5:32 pm

    Done it in three countries. As a sperm donor in the UK and Australia, and as a known donor at a private clinic in Belgium. Tatty porn was provided in all three places, but no tea or biscuits, and the process was far from edifying. Still without it, my eight-year old daughter wouldn’t be here, and I’ve presumably helped some other families bring children into the world.

    elpenordignam said: “My issue is not so much with my taxes being spent on pornography but rather the promotion of masturbation by the NHS.”

    Umm, what’s wrong with masturbation?

  17. chrisdunst said,

    November 10, 2010 at 7:50 am

    Its really a disgraceful thing to do at a place like hospital. It should be condemn by all.