The psychological impact of infertility on men

Infertility affects approximately 15% of couples in developed countries, and in half of cases, the cause is related to the man. Although research has mostly focused on women, men also experience pain, loss, and stigma when faced with infertility. In this post, we summarize findings from the scientific literature to shed light on how men often feel about this experience.

These are general trends and observations that help to understand the bigger picture. However, it is important to emphasize that every case of infertility is unique and that individual experiences may differ from general patterns.

Reactions to diagnosis

Stress, anxiety and depression

Research shows that men generally experience less pronounced depression and anxiety when diagnosed with infertility than their female partners, but the impact is still significant.

In a study of 113 Australian men, mean scores for depression and anxiety were lower than for women ( 6.3 vs. 9.1 for depression and 34.6 vs. 38.7 for anxiety). Similarly, a British study found lower scores on the Beck Depression Inventory in men. However, half of the men in one of the larger studies reported at least mild distress due to infertility.

A Slovenian study of 1,076 men found that 19.9% ​​of participants had clinically significant anxiety, while depression was less common. This confirms that men are not immune to the psychological consequences of infertility, although their symptoms may be milder than in women.

The desire for fatherhood and social pressures

The notion that men are less likely to want to become parents is false.
In a German survey of 1,580 participants from the general population, 34.1% of men and 45.9% of women who had not had children wanted to have one. In the 31-40 age group , the proportion was the same: 49% .

In an Australian study, five years after being diagnosed with infertility, 84% of men still expressed the same strong desire to father children as their partners. However, societal pressure to be strong often leads men to hide their struggles.

Research is not unanimous on whether men experience more distress when their infertility is the reason for their inability to conceive. A smaller study found that they more often experience feelings of loss and stigma in this case, while larger analyses did not confirm the differences.

Self-esteem, masculinity and coping

Factors that predict distress

An analysis of 167 men found that four factors together explain about a third of the variance in distress levels:

1. general mental health,
2. self-esteem,
3. attitude towards traditional ideas about masculinity,
4. satisfaction in partnership.

The strongest predictors were low self-esteem and a strong traditional idea of ​​what it means to be a man . Satisfaction in the partnership did not have an independent effect, but was associated with other factors.

Coping strategies

Men typically deal with infertility differently than women. They often take on a greater sense of personal responsibility and less self-blame.

Avoiding the problem and not seeking social support are associated with greater depression and anxiety, while seeking information and actively solving problems reduce stress. An analysis of several studies has shown that men are less likely to seek support from others. Many turn to work or hobbies, which helps distract their thoughts, but does not eliminate the feeling of loss.

Impact on partnership and social environment

Sexuality and partnership

Infertility also affects intimacy in a couple. In a German study, men with prolonged infertility reported a decrease in sexual intercourse frequency. In an Iranian study, 41.5% of men reported a decreased sexual desire and 52.5% reported a decrease in sexual satisfaction after diagnosis. In an Australian study, 25% of men believed that infertility had worsened their relationship, and 32% reported a decrease in sexual satisfaction.

Social support and shame

Stigma and shame often prevent men from seeking help.
In a Swedish study, almost half of men did not trust anyone other than their partner. Among those they trusted most often were friends (38%), mothers (27%), and fathers (23%).
An Italian study found that men receive less support than women.

Anonymous online communities have proven to be a place where men can more easily express their emotional pain, often mentioning that they want to protect their partner from additional burdens. Formal forms of help are less frequently used:
A French survey found that only 10% of men had visited a psychologist , although 66% thought that help should be available. In an international survey, only 8.9% of men expressed a willingness to attend an infertility education course.

In short

Infertility in men is not only a physical challenge, but also a psychological and social one. Although symptoms of depression and anxiety are often milder than in women, about half of men experience at least mild distress. The strongest factors associated with greater distress are low self-esteem, traditional views of masculinity, and mental health problems. The consequences are also reflected in sex life, relationships, and social isolation.