Academic journal article International Journal of Men's Health

Infertility Problems and Mental Health Symptoms in a Community-Based Sample: Depressive Symptoms among Infertile Men, but Not Women

Academic journal article International Journal of Men's Health

Infertility Problems and Mental Health Symptoms in a Community-Based Sample: Depressive Symptoms among Infertile Men, but Not Women

Article excerpt

Most researchers agree that men's and women's experiences of infertility are fundamentally different, and impacts upon the nature of psychological distress encountered. However, design flaws, including non-random samples unrepresentative of the general population, compromise many existing studies. Data derived from a random general community sample provides prevalence of current infertility, and permits examination of longitudinal associations between mental health symptoms and infertility among 1,978participants aged 28-32 years. In the previous 12-months, infertility was experienced by 2.1% and 5.4% partnered men and women. Infertility independently predicted depressive symptomatology in men, and anxiety symptoms among women. Gender differences were sustained, even controlling for prior depression and anxiety. Health professionals are encouraged to proactively enquire about affective symptoms experienced by both women and men with infertility problems.

Keywords: infertility, mental health, general population sample, men's health, gender differences


International estimates suggest nearly 1 in 10 people experience infertility (Boivin, Bunting, Collins, & Nygren, 2007). Rates vary considerably between countries and cultures as Boivin et al. (2007) illustrate, however in developed countries infertility is expected to further increase as delaying childbearing continues (Dunson, Baird, & Colombo, 2004; Sartorius & Nieschlag, 2010). A combination of rising obesity rates, competing career, education and interpersonal demands, and ignorance of the age-related decline in fertility are key protagonists in intensifying rates of infertility (Hammoud, Gibson, Peterson, Meikle, & Carrell, 2008; Schmidt, Sobotka, Bentzen, & Nyboe Andersen, 2012; Virtala, Vilska, Huttunen, & Kunttu, 2011; Wang, Davies, & Norman, 2002).

Importantly, the experience of infertility is frequently described to be a major life stress (Abbey, Andrews, & Halman, 1995). Indeed, some conceptualise infertility as a crisis "caus[ing] both physical and psychological stress" (Sreshthaputra, Sreshthaputra, & Vutyavanich, 2008, p. 1769). However, while there is an extensive body of literature focusing on women's distress and psychological symptomatology in relation to infertility, there remains a much smaller focus on men with infertility problems and their current mental health status (Fisher & Hammarberg, 2012).

Gender and Infertility

Frequently, only one person within a couple is medically diagnosed as infertile (Jordan & Revenson, 1999); that is, where pregnancy has not been achieved after 12 months attempting to conceive (Mosher & Pratt, 1991). Research highlights that women are consistently more likely to instigate investigations into infertility issues, commonly attending initial clinical investigations alone (e.g., Greil, Leitko, & Porter, 1988; Meerabeau, 1991). This may be a consequence of differences in the physical and social awareness of fertility. Post puberty, the majority of women are regularly reminded of their integral role in reproduction by menstruation (Foster, 1996), and variation from a woman's "normal" menstrual cycle is usually apparent to her. Further, a "pervasive naturalisation and normalisation of motherhood ..." (p. 333; Throsby & Gill, 2004) impels women to become mothers (Culley, Hudson, & Lohan, 2013). In contrast, men are generally reliant on information from their partner to establish their own procreative status (Marsiglio, 1998), and contrastingly, fatherhood appears to be less central to the male social identity (Greil, Leitko, & Porter, 1988) where social normalcy for men is still achievable via alternative pathways, such as successful careers.

Infertility is "a fundamentally different experience for women... [and] men" (Greil, Slauson-Blevins, & McQuillan, 2010a, p. 141). The process of discovering a fertility problem, perspectives on courses of action, and possibly subsequent infertility treatment, vary with both biological sex, and gender role and identity (Hudson & Culley, 2013; Marsiglio, 1998). …

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