Psychological and social aspects of infertility in men: an overview of the evidence and implications for psychologically informed clinical care and future research

Abstract

Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology (ART) treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility-related grief and shame among men. Few resource-constrained countries have any data concerning male experiences of infertility.

Catch 22? Disclosing assisted conception treatment at work

“…The experience of infertility or involuntary childlessness (the preferred term used in this paper) is also influenced by the social context in which it takes place, including socioeconomic status, religion, culture, gender, gendered practices and direct and indirect messages women and men receive (Bell, 2016). While women using assisted conception experience greater levels of distress than men (Greil, Slauson-Blevis, & McQullian, 2010), men too may need to cope with anxiety or depression (Fisher and Hammarberg, 2012). They may invest time and emotional efforts into diagnostic investigations and providing sperm samples, as well as supporting their partner through the numerous tests and invasive treatment processes.…”

Correlation of Seminal Plasma Total Antioxidant Capacity and Malondialdehyde Levels With Sperm Parameters in Men With Idiopathic Infertility

“…Studies in normal couples reveal that 90% of them will conceive within one year of unprotected intercourse. Thus, the classic definition of infertility became the absence of conception after one year of regular and unprotected intercourse (1). However, because a small number of normal couples will conceive between 12 and 24 months, the world health organization (WHO) has suggested that absence of conception after 24 months of unprotected intercourse is the preferred definition of infertility (2).…”

Perception of the Psychosocial Aspects of Subfertility by Parents Following Successful Medically Assisted Conception: A Qualitative Study

“…The negative consequences found in many studies and reviews included increased levels of stress, confusion and anxiety [5] [6] [7], decreased satisfaction with the couples' relationship and sexuality [8] [9], decreased satisfaction with social life and, in unsuccessful treatments, hampered grieving [10] [11] and lasting sadness [12]. These negative consequences are found in both men and women, and while some authors suggest these consequences may be somewhat stronger in women [8] [13] [14], others did not [12] [15]. A successful fertility treatment does not resolve all negativity, as parents who conceived through fertility treatment had higher levels of anxiety in early pregnancy [5] [16] and perceived pregnancy as being more risky and demanding [17] [18].…”