Split the Problem from the Shame: the Psychology of Male Infertility

Male infertility is a condition in which a man is incapable of fertilizing a woman's egg due to some deficiency in his reproductive system, likely the sperm it produces. Infertility can be dispiriting and even embarrassing for the men it afflicts.

For more reserved men who struggle to express emotions, infertility can be particularly troubling. Cultural pressures exacerbate the problem: Studies have found that social preconceptions about men and sexual potency feed feelings of inadequacy and reinforce a reluctance to discuss the problem.

A 2003 study of masculinity and reproduction published in the International Journal of Men's Health found infertility to be emasculating and more stigmatizing for men than for women. Furthermore, the report concluded that men are apt to conflate infertility with the loss of virility and potency, and to feel they are less masculine because they are unable to produce a child.

A 2004 report published in the journal Social Science & Medicine added that Western societies foster a stereotypical image of masculinity that discourages vulnerability and emphasizes toughness, posturing that makes it difficult for men to admit they have a problem that requires help. Other studies have found that infertility can cause a man's negative self-image to extend beyond reproductive inefficacy into other aspects of his life. In other words, it becomes difficult for a man who feels his masculinity is threatened to compartmentalize his anxiety.

An important first step

Clearly, there is a strong connection between male infertility and low self-image, particularly when sociocultural expectations are in play. Considering that roughly one-third of infertility cases among heterosexual couples can be attributed to male fertility problems, these emotional problems are especially important to address. Overcoming shame and stigma, though challenging, is necessary to deal effectively with a problem that undermines a man's sense of identity as well as, potentially, the stability of his relationship.

Unfortunately, some infertility issues, such as chromosomal problems, are irreversible; but many others are treatable. Finding out what treatments are available—there are many options—can be an empowering first step for an infertile man. Some surgery options may restore fertility by removing any blockages that might be present. There are also special treatments for men with hormonal imbalances and intercourse problems, such as erectile dysfunction (ED). In some cases, assisted reproductive technology (ART) can be used to extract sperm and fertilize a woman's egg.

Fear of the unknown

The first step in identifying appropriate treatment is to have an honest conversation about the problem. This can be difficult for anyone, but men who see themselves as paragons of virility may find it nearly impossible to talk openly about or accept infertility.

Some avoid the subject for fear that a partner may see them as not masculine enough to father a child and, therefore, not worthy of love and respect. A man may even worry that simply acknowledging infertility will mean the end of his relationship. Even male fertility testing can present an obstacle for men who are squeamish about producing a semen sample by masturbating in a medical office or clinic (individuals from a strict spiritual background may even resist semen testing on ethical or religious grounds).

Find a comfort level

When a man can't bring himself to confide in a loved one, it's important he finds a comfortable starting point to get past the fertility-equals-virility mindset. A man may be more comfortable, at least initially, talking in a more formal setting with someone like a urologist or a reproductive endocrinologist.

Help may also come from a website or an app. A web search will reveal sites and apps dedicated to helping men work through infertility issues and find comfort in information. Gathering data and reaching a truly informed understanding of male infertility can help a man set aside cultural misgivings and fear of the unknown.

Understanding makes it easier to accept that male infertility is not a tacit acknowledgment of shame or failure. It is a highly treatable condition in most cases and nothing that a man should feel distressed about.