Everyone faces stress in their lives but research shows some life events – the death of someone close, a divorce, or loss of a job – have a bigger impact than others. Add infertility to the list as causing major stress: evidence shows that women faced with infertility have stress levels comparable to being a cancer patient.
But what about men?
First, the facts: according to the American Society for Reproductive Medicine (ASRM), in approximately 40% of infertile couples the male partner is the sole cause or contributing cause of infertility. Still, too often when people think about infertility, the focus is on women and, until now, there’s been very little research on how infertility affects a man’s stress level. Unfortunately, this gap affects men and women by not acknowledging the issue, including finding support to help men cope.
Three new studies presented at the annual ASRM meeting in October reveal how infertility can cause high stress levels in men. This has implications for relationships and quality of life – including one’s sex life. Stress has also been shown to reduce the quality of sperm and semen.
Researchers at Northwestern University recruited 98 male patients at infertility clinics to participate in a study designed to assess their stress levels, emotional responses and coping skills. The study revealed that men feel a “threat to their future fatherhood” and an “emotional loss and distress” from infertility in general. Their stress levels rose when there was a diagnosed abnormal semen analysis.
This finding is supported by an earlier study that suggested a man’s reaction may depend on whether he or his partner are diagnosed as infertile. Men do not report being as distressed as women when the infertility is diagnosed in their partner. When men are diagnosed as having the infertility problem, they experience the same levels of low self-esteem, stigma, and depression as women.
Stress associated with semen collection and analysis that is part of a standard infertility evaluation for men was examined by researchers from the University of Cincinnati. While most men did not find it “overly stressful,” a third of those surveyed said they experienced “increased levels of stress and embarrassment.” A small number of men also reported that semen collection caused a decline in their libido.
Finally, a small study conducted by the University of Michigan surveyed twenty-five men at an infertility clinic. Those receiving infertility evaluations reported “moderate levels of stress, a decline in sexual confidence and reduced erectile function.” This study adds to the limited body of knowledge on men’s experience with being evaluated for male-factor infertility according to the study authors. They also suggest that men should be offered support for their increased stress and decreased sexual confidence.
While it’s certainly not good news that research concludes that men also experience stress when dealing with infertility, it is positive to acknowledge and document it. According to Peter Schlegel, MD, Vice President, ASRM “Too often the stress levels and emotional needs of men have not been considered when dealing with an infertile couple.” He adds that research results underscore the need to deal with all the factors that couples face dealing with infertility and trying to get pregnant.
The researchers at Northwestern agree, suggesting that “careful consideration of both men’s and women’s emotional needs” will help them maximize how closely they follow treatment requirements and get a successful outcome. Further, men should have access to care team “collaboration” such as having mental health professionals available whether receiving treatment in urology or at infertility clinics. This approach is consistent with treating the “whole patient” as is more common for other medical conditions.
Besides the stress of an infertility evaluation and diagnosis, treatment issues may also add stress with medication side effects, money worries and uncertainty about the outcome. Men and women are likely to use different coping strategies to deal with the stress from infertility. Women more often seek social support such as participating in an infertility support group while men may try distancing and problem solving.
Whatever gender differences there may be, there are techniques that can help men and women effectively reduce stress – either individually or as a couple – including counseling, mindfulness and relaxation techniques, yoga and exercise.
The psychological challenges of infertility can be overwhelming but ultimately there is some type of resolution — hopefully one that includes becoming parents. Be sure to talk to your doctor about how best to evaluate and treat your stress and get a referral as needed. After all, effectively coping with stress is a skill all parents need!