The Dark Side of Male Infertility

He sat down in front of me, looked me in the eye and told me that if I cannot find sperm, then he will divorce his wife in the Middle East. If he can’t provide seed for her to bear a child, then he is not worthy of being married to her. OK, that put the pressure on me, to say the least. But it also brought to light the absolute gravity of this disease called male infertility.

A Lonely Number

Man crying
Painting of a many crying (

In my practice, I see a lot of men with no sperm in the ejaculate. I’ve described what I call “That Azoospermic Feeling” before, and believe me, facing a diagnosis of absolute infertility is one of the loneliest experiences a man can have. We reiterated this point in a paper published a couple of years ago with my colleagues from UCSF. We observed that men diagnosed with male infertility suffer intense negative sexual, personal and social strain, findings typical for illnesses like cancer.
Just recently, an NIH-based study extended these observations. Among 3200 infertile men and women, they found that depression among infertile men was quite common. In addition, male depression was associated with lower pregnancy rates, a finding that was not observed in women. What gives? To me, it makes sense as depression can lower sex drive and cause erectile and ejaculatory dysfunction, all of which could lead to less sex and fewer pregnancies. So, infertility is not simply just another daily stressor, but is likely a lot more than that. Stress a man out long enough and depression sets in. And that in turn sets up a vicious cycle in which failure to conceive (while having sex) leads to more failure to conceive (because of no sex). Now that is ugly.

Got Your Number

Here are the simple truths regarding the dark side of men and infertility:

  • Infertility affects men’s self-esteem and self-identity similar to other mortal challenges. You were put on this good earth to reproduce, and yet you can’t? This goes deep.
  • Feelings about fertility and sexual adequacy are interconnected for many men.
  • Infertility has long-term emotional ramifications as it is often a secret kept from others that can lead to isolation and desperation.
  • Infertility causes many men to question their masculinity.
  • Male infertility can carry a social stigma that relates to sexual prowess.

You might not have guessed that all this stuff swirls around within the minds of men. But it does. Just ask them. You’ll uncover a world that you never knew existed. And you may help rescue a man drowning in a sea of emotions.

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