Ryan, a media entrepreneur, was also driving when he first heard that the numbers weren't adding up for him either. He had been married to his wife, Suzanne, for three years and their attempts to start a family were not working. "We came to the conclusion that there was something amiss. That something was not in line as it should be. I rang my GP from the car and he told me that some tests I had taken had come back and that they were marked abnormal. I nearly crashed."

Up till then Ryan was a man in control of his life. Successful in his business and relationship and with a fine home in a nice part of town, he was now just a puzzled man in a car coming to terms with the evocatively named condition 'Oligozoospermia, ' or a low sperm count. He was amazed by his reaction.

"I was completely devastated. It came from so far out in left field all I could think was . . . what should I have done different?

Should I have been taking it easy on the gargle, should I have been smoking fewer cigarettes . . . it was just a big shock. I was dealing with it almost surreally, like I was in some kind of zone." Questions began to fill his mind while he worked out what to do next, and several years later he feels that they have still yet to be answered.

The problem for Ryan is that such an important issue is a taboo subject for half the population? Why is it so difficult for a man to say aloud that he badly wants a baby but that he cannot make one?

"My theory is that some people feel they are less of a man if they have some kind of fertility issue. Some see it as a threat to their manhood. Maybe it's an Irish thing, a male thing. We don't talk about contraception. We don't talk about vasectomies, we don't talk about IVF."

One in six couples experiences difficulties getting pregnant and male fertility problems are responsible 35% of the time. Yet in Ireland Ryan sees it as the condition that "dare not speak its name".

"I remember feeling that it was extremely difficult to talk about and it was only when some of my closest friends coaxed it out of me that I could. I wasn't volunteering any information. I don't know why that was so, I just didn't want to deal with it. I felt it was a private matter.

"I was fortunate that I had good friends that I could be graphically open with and believe me, there are some aspects of the IVF process that do bear a fair bit of graphical discussion."

The science part he found to be intriguing.

"Once I started it was relatively easy . . . I was so focused on making it work. You just keep at it until it is done. It just becomes a big process. Everything involving technology has wires and I drew great comfort from that, actually. I had these visions of canisters of smoking nitrogen which I didn't see, but as far as I was concerned the more technology the better . . . bring it on."

After a year of treatment, a home pregnancy test showed positive. On their way to the clinic for the first scan, he and his wife noticed a pair of herons resting on a chimney stack and both had the same idea. "We both thought . . . wouldn't it be really cool if it was twins, " says Ryan. The following July two perfect twin girls were born. But the questions still remain for him.

"Why is it that women find it easy to talk about fertility and men don't? I must have been approached by up to 50 guys in the last few years to ask what it is all about. It affects one in six of us."

FACTS ON IVF
>> Since the world's first 'test tube' baby, Louise Brown was born in July 1978 over three million babies have been conceived by this method. By 2006, over 1,000 babies have been born in Ireland using this IVF.

>> Although the treatment can only be purchased privately in Ireland, it is free in many European countries. In Germany and France a couple can have three cycles of treatment free of charge.

>> One single treatment cycle in Ireland will cost the couple an estimated 4,000.

>> 16% of Irish couples experience difficulties with becoming pregnant.

>> The oldest successful mother to use the technique was a retired Romanian University Professor who gave birth at the age of 66 in 2005.

>> Smoking seriously reduces the success rate. In one study 32% of women with non smoking partners became pregnant. If the partner smoked the success rate dropped to 18%. The success rate for women smokers is 28% lower than for non-smokers. Passive smoking also negatively affects the chances of success.