Not Yet a Dad: Coping with Male Infertility

infertile man

As an infertility counselor, I’ve never had a man come in for counseling by himself to deal with the psychological effects of an infertility diagnosis. Women seek therapy with me; sometimes couples do; never has a man alone.

Male infertility – What is it?

At least 30% of infertility in couples is the result of male issues – mostly low sperm count, poor sperm quality, or both. Other causes of infertility in men include hormonal imbalances, genetic defects, and problems with anatomy.

Of course, some men are also affected by the infertility of their female partner or a diagnosis of “unexplained infertility” for the couple.

The psychological effects

Researchers have completed many more studies about the psychological effects of infertility on women than on men. Some studies have suggested that women suffer more severe effects than men. Others have suggested that men suffer just as much, but differently.

reduced self-esteem – anxiety – depression – shame – humiliation – sorrow – loss of dignity – stigma – sexual inadequacy — loss of sense of masculinity — poor quality of life

This long list represents the devastating effects that an infertility diagnosis can have.

How men cope

Often men deal with the effects in silence, turning neither to friends, family, nor professionals for help. Studies have shown that they are less likely than women to discuss their infertility diagnosis and feelings about it with others.

What’s more, many men focus more on their partner’s needs than their own feelings. They believe they must be strong for their partner and protect her during this traumatic time.

Some researchers have suggested that men tend to be able to compartmentalize feelings and thus can appear not to be affected deeply by infertility and the process of treatment.

couple and baby

How therapists can help

  • Collaborate with fertility clinic physicians and nurses to help them understand the signs and symptoms of emotional distress and learn when to refer men for psychological counseling. Or become an integral part of a treatment team. At least on study has suggested that men are more willing and likely to seek help for emotional distress from infertility clinicians than from friends or counselors.
  • Develop educational materials about the emotional side of male infertility and how counseling can help.
  • When working with a couple, understand the deep effect of male shame on both the man’s self-appraisal and the couple’s distress.
  • Offer support groups for couples and use the group to help men explore and share feelings and develop coping skills. Normalizing common emotional responses to infertility is important, especially for men.
  • Know enough about the medical side of male infertility and its treatment to be able to talk comfortably about the situation with male clients.
  • If you are a male therapist, develop competency/expertise in infertility counseling, focusing on men. We need more men working with men in the field.

Hope for parenthood

With so much complex medical technology available today to treat infertility, many men with infertility diagnoses will go on to become fathers–sometimes within months, sometimes waiting for years. Some with turn to adoption or sperm donation to become parents.

It’s important to maintain hope when working with infertility patients, and it’s also important to understand that some men will experience chronic sadness and complicated grief at the loss of having a genetically related child. Sometimes the role of the therapist becomes to help work through this sorrow and move toward acceptance.

Susan B. Saint-Rossy is a therapist who works with couples and individuals, and has a specialty in infertility counseling. She is a  PACT (Psychobiological Approach to Couple Therapy) Level 2 Clinician and is also trained in EFT (Emotionally Focused Couples Therapy) and the Gottman Approach to Couples Therapy. She is a clinical social worker licensed in Virginia and Washington, DC.


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