New Delhi

Among couples of all ages who have been trying to conceive a baby and are unsuccessful after several attempts, would you believe that 50 per cent of the time, infertility stems from the man? It’s not me exaggerating these numbers but according to the World Health Organization, in all of the infertility cases reported in India, 50 per cent are due to the “male factor” and the woman is usually sexually healthy to produce. You hardly ever hear this though. It’s often a lack of awareness that puts the blame for being infertile on the woman (without any medical proof) and she is then subjected to society-inflicted trauma and ostracisation. But that is a topic for a separate discussion. 

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Infertility among men refers to a condition where a man is unable to cause a pregnancy in a fertile female, due to a sedentary lifestyle, poor life choices, insufficient nutrition in diet and many other related issues. This leads to anxiety and stress that then affects his family life, interpersonal relationships with immediate family members, including his partner, and mood in general. To sum it up, he is unhappy and discontent. If not recognised and treated early, this then translates into a mental health issue. And we know how unhappy we are as a generation!

How to approach the issue of infertility in males?

To understand how we can deal with this situation delicately and not let infertility cause mental health issues, WION spoke to Diana Crasta, Chief Psychologist at Nova IVF Fertility. She addressed the fragile relationship between physical and mental health, how to lead a healthy life and approaching infertility issues as a team rather than a ‘me vs you’ thing. 

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Happy with the progress in the psyche of her clients today (men and women), Diana said that while fertility challenges faced by men have received less attention, compared to women, and is still a hush-hush topic in many states, there has, however, been a gradual shift in recent years towards recognising and discussing male fertility problems. While the cultural and societal norms surrounding male fertility can vary across different regions and communities, there are indications of progress in terms of men being more open about facing fertility issues.

“Increased awareness campaigns, medical advancements, and changing societal attitudes have contributed to this shift. It is important to emphasise that cultural stigmas and taboos surrounding male fertility issues may persist in certain societies. These stigmas can hinder open discussions and prevent men from seeking essential medical assistance. The prevailing pattern, however, indicates a growing normalisation of the discourse on male fertility, with men increasingly willing to address their reproductive challenges,” she said. 

The best approach she lists is to tie this down to the couple vs an individual. This helps in not making one person in the couple guilty of being ‘unfit’ to copulate. “The first step is couple counselling,” said Diana. 

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Best ways to get men to address the issue in front of an expert

On how psychologists must tread down the sticky slope and build a safe and supportive environment for the individual to express their concerns, Diana lists some things she does while approaching them.

● Establish rapport and trust: Build a stronger therapeutic alliance by actively listening, demonstrating empathy, and showing genuine care and understanding.

● Validate emotions and normalise experiences: Acknowledge and validate the individual's feelings surrounding male fertility concerns. Help them understand that it is natural to experience a range of emotions, including frustration, sadness, or anxiety.

● Provide psychoeducation: Educate the individual about male fertility, including the factors that can contribute to fertility problems and available treatment options. Help them understand the physiological and psychological aspects of male reproductive health

● Collaborate with a multidisciplinary team: Recognise the importance of a multidisciplinary approach to addressing male fertility concerns. Collaborate with medical professionals, such as reproductive specialists or urologists, to ensure comprehensive care. Lastly, we just need to remember that every individual is unique, and it is crucial to tailor your approach to their specific needs, values, and cultural background.

Building a rapport for effective communication

But it’s easier said than done, points out Diana, who admits it's quite challenging to get males to talk about their infertility. Oftentimes, she has seen that men expect women to be seen by psychological counsellors first. “By establishing a rapport and helping them identify the problem at its root, we provide them with a holistic picture of their concerns. By sharing similar journeys of patients such as themselves, support group meetings, we help men open up. This is a long-term process, and the results are not witnessed in the first, initial meeting but with time and efforts,” said Diana. 

Getting men to express their concerns is challenging but of utmost importance because not addressing the elephant in the room can have dire consequences – from marital discord to mental health issues. Diana agreed and added, “Infertility affects mental health to a great extent. It can lead to significant stress and anxiety, and couples may experience a sense of loss, low self-esteem, and these factors can put a strain on their relationships. In these cases, we want the couple to be one team and pass this storm together.”

She continued, “Mental health and fertility issues are intertwined, with each impacting the other in diverse ways. The challenges of fertility struggles can result in notable stress and anxiety. The emotional burden of attempting to conceive, undergoing fertility treatments, or facing recurrent pregnancy loss can intensify stress levels and contribute to feelings of sadness, grief, and depression. In addition, fertility challenges can put a strain on relationships, causing conflicts, misunderstandings, and decreased intimacy. It can have an impact on mental health and well-being, further exacerbating the stress associated with fertility issues. Conversely, pre-existing stress and anxiety can also affect fertility by disrupting hormonal balance and impacting reproductive functions.”

But what helps these health professionals is that more people are now ready to recognise the problem at hand and seek help. “When patients come to us these days, what helps is that they are ready to reconcile, face the problems and deal with the issues. By facilitating this process, we help couples work together as one team and support each other in their fertility journey. We help couples understand how important it is to be positive in their journey toward parenthood and staying happy in general,” Diana reflected. 

Balancing physical and sexual health

Physical and sexual health goes hand in hand. Hence, it's important to keep both in check for a happy life. She shared with us some tips to adopt a healthy lifestyle, which includes taking care of both your body and mind. 

Here are some tips to stay healthy on a daily basis:

  • Keep your body nourished, and eat a well-balanced diet rich in green vegetables, whole grains, legumes, fruits, and iron-rich foods. 
  • Maintain a healthy sleep schedule by ensuring 7-9 hours of sleep per night. 
  • Avoid substance use, such as smoking or drinking. 
  • To effectively handle stress, develop healthy coping techniques such as exercise, meditation, and deep breathing.
  • Spend time with loved ones and go on dates.
  • Schedule regular health check-ups to monitor your overall health and detect any potential issues early. 
  • Stay physically active. Engage in regular moderate-intensity exercise, such as walking, swimming, or cycling. Regular physical activity helps regulate hormones, improves blood circulation, and supports overall health.
  • Maintain strong relationships with family, friends, and others in your community. Strong social ties increase happiness, decrease stress, and improve general well-being.
  • In addition to this, consider prenatal supplements if you are planning to conceive. Prenatal supplements that contain essential vitamins and minerals like folic acid, iron, and vitamin D can be beneficial for some.