The hidden trauma of male infertility
There has been a lot of alarm in recent years about the declining fertility rates of Western men and the potential problems this may pose.
It is estimated that infertility affects one in six heterosexual couples, making it a common issue for those of reproductive age. For 40% of couples who can't conceive, the problem lies with the man. But despite this, fertility remains something that is traditionally viewed as a "woman's problem", with male infertility rarely spoken about.
This focus solely on women's bodies and perspectives, often leaves men feeling unable to speak out or even talk about their own infertility and the impact it has had upon their lives. And our previous research has shown infertility can be a very difficult and stressful experience for men to go through. Many men find fertility diagnosis and treatment highly traumatic. A time which was often likened to a "rollercoaster" – with a lot of men reporting feelings of sadness and despair.
Our latest study has built upon these findings to delve deeper into men's experiences. And we found that many men were deeply affected by infertility – with some identifying it to be the most difficult experience of their lives.
Getting to the truth
Working with Fertility Network UK – the national fertility charity – we designed and distributed a questionnaire with a series of open-ended questions which allowed men anonymously to tell us about their infertility journeys.
Despite infertility still being seen as a taboo topic for men, we received a large number of completed questionnaires, offering rich, detailed accounts. Most respondents said it had affected their psychological well-being, mentioning anxiety, depression and stress-related ill health in their accounts.
In this way, the inability to conceive was often likened to grief, and many of the men felt that it took time and considerable emotional energy to manage such feelings of loss. One man explained how it had impacted his life:
"It's in our DNA to make babies. That's the purpose of sex when you are older is to make babies. It made me feel worthless that I couldn't have kids."
Many respondents framed the impact in gendered terms, which is perhaps to be expected given the traditional associations between masculinity, fertility and fatherhood. One man said:
"It made me feel less of a man at the time knowing I may never father a child."
This sense of emasculation was compounded by the widespread assumption that reproduction for men is a simple, natural process – as another man detailed:
"For a while I thought less of myself as a person and as a man. I felt it was nature's way of telling me there is something wrong with me and that's why I am not able to have kids."
Such challenges to men's identities – which are linked to dominant ideals of masculinity – can be difficult and often make men feel further isolated when dealing with fertility issues.
Silence and stigma
Clearly, an ongoing stigma surrounding men and infertility contributes to men's suffering. And this leads to many men coping with infertility in silence. Infertility can also create challenges within relationships between couples, further adding to the burden many men feel.
But the situation is slowly beginning to change, with more men coming forward to tell their stories and share experiences – often on online support forums. Using these online spaces to get help and advice is often valued by men, not only because they are anonymous, but also because many men find it hard to get support "in real life".
In this way, sharing with others who understand and have been through similar experiences can help men feel less isolated. And it can also provide support, understanding and camaraderie not encountered (or sought) in their interactions within health care settings.
But ultimately, as our research shows, men's perspectives and emotions need to be recognised more during the process of fertility diagnosis and treatment. And more should be done to make sure they are well supported and given advice that is gender sensitive.
By starting conversations and educating people about fertility, it will become easier for men to speak out and to access the support they may need when going through a highly emotional and challenging time in their lives. This is important because the silence that exists around infertility in society is very real and can be very damaging for so many men.