Jul 4 2007
Although most psychosocial research into infertility is centred round the unhappiness it causes women, men suffer just as much, a scientist will tell the 23rd annual conference of the European Society of Human Reproduction and Embryology today (Wednesday 4 July).
Ms Laura Peronace, from the School of Psychology, Cardiff University, Wales, UK, will say that, as compared to the use of formal counselling, the development of appropriate support networks for infertile patients is more likely to be used by couples and therefore lessen their unhappiness.
Ms Peronace and her team set out to see whether men with male factor infertility, for example through sperm deficiencies, suffer more than men where the couple's infertility comes from the woman. "There is a common belief that being unable to father a child is shameful and emasculating", she says, "and it is thought that if the man is the source of the couple's failure to conceive he is likely to suffer more emotionally than if the problem lies with the woman." However, she says, most studies have focused on men shortly after their infertility was diagnosed, and few have looked at their well-being during the course of treatment.
The scientists selected 256 men from the Copenhagen Multi-Centre Psychosocial Aspects of Infertility (COMPI) research programme. Most men were in the mid thirties, and had been married, on average, for almost 8 years. They had known that they were infertile for over 4 years, and the majority of couples had no children either together, or from previous relationships. Participants completed a series of questionnaires that included measures assessing physical health, support, and psychological and social stress. They completed the questionnaire before the start of treatment, and again after 12 months of treatment, only if their partners had not become pregnant during this time. The men were divided into four categories; unexplained infertility; female infertility; male infertility; or mixed. "We found that social stress, marital stress, coping effort, and physical stress increased over time, whereas mental health decreased", says Ms Peronace. "Perhaps surprisingly, though, we found that men in all four groups suffered equally. Infertile people appear to rely particularly on their social environment for support, and this seems to deteriorate over time. Couples should be made aware of the possible decline in their social support network and encouraged to organise support systems that no not solely include close friends and family."
Counselling in the early stages of infertility is not often a desirable option for couples, and especially for men, say the scientists. Couples should be encouraged to focus on their partnership and communicate with each other in a mutually supportive way. They might also be directed to online support services, and given the chance to speak to other couples with fertility problems
"But psychosocial counselling may be beneficial and more readily accepted in the later stages of treatment, when social networks are at their weakest, and also after repeated treatment failure", says Ms Peronace. "Men who are particularly affected by fertility problems should be considered for counselling, since this may improve their mental well-being as well as their perception of their social environment. Given the level of suffering we found among men, it is important to continue to research into their needs."