Male Infertility – What about Mental Health? - Revista Brasileira de Ginecologia e Obstetrícia
Rev Bras Ginecol Obstet. 2023;45(10):620-621
Infertility is the inability to achieve a clinical pregnancy even after engaging in regular and unprotected sexual intercourse for 12 months, during the fertile days; roughly 8% to 12% of couples of reproductive age worldwide are believed to be affected by infertility. While males are solely responsible for around 20% to 30% of infertility cases, overall, they contribute to half of the cases. It is well known that infertility may induce stress on couples who fail to conceive, but it is unclear whether psychological stress causes infertility. Determining the emotional and psychological impact of male infertility and knowing whether it can improve outcomes if addressed is one of the priorities of male infertility research. Infertile men generally suffer silently, and consequently report lower levels of psychological distress in questionnaires; considering that the concepts of male fertility and virility are part of the perception of masculinity, it is not illogical to assume that there is a social concern that could influence male sexual and reproductive health. A study has found that the pessimism and psychological distress reported by male partners in couples undergoing in vitro fertilization had a negative linear correlation with clinical pregnancy. This might be due to the fact that psychological stress reduces sperm count, progressive motility, and increases abnormal morphology. Another study found an inverse relationship between erectile dysfunction and quality of life measured through the fertility quality of life tool (FertiQoL) and a significant relationship between depression and erectile dysfunction. Additionally, a prospective study suggested infertile men are generally less healthy than their fertile counterparts when considering overall health.
It is unclear whether psychological interventions would be helpful to infertile males; a meta-analysis found a non-significant relationship regarding psychological interventions and depressive symptoms and anxiety in men from infertile couples. However, a systematic review found cognitive behavioral therapy and mind-body interventions proved to be effective psychological interventions, with some positive effects on anxiety, pregnancy rates or marital function, and that coping therapy may be used to reduce stress and anxiety in the waiting period before the pregnancy test.
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Infertility is the inability to achieve a clinical pregnancy even after engaging in regular and unprotected sexual intercourse for 12 months, during the fertile days; roughly 8% to 12% of couples of reproductive age worldwide are believed to be affected by infertility. While males are solely responsible for around 20% to 30% of infertility cases, overall, they contribute to half of the cases. It is well known that infertility may induce stress on couples who fail to conceive, but it is unclear whether psychological stress causes infertility. Determining the emotional and psychological impact of male infertility and knowing whether it can improve outcomes if addressed is one of the priorities of male infertility research. Infertile men generally suffer silently, and consequently report lower levels of psychological distress in questionnaires; considering that the concepts of male fertility and virility are part of the perception of masculinity, it is not illogical to assume that there is a social concern that could influence male sexual and reproductive health. A study has found that the pessimism and psychological distress reported by male partners in couples undergoing in vitro fertilization had a negative linear correlation with clinical pregnancy. This might be due to the fact that psychological stress reduces sperm count, progressive motility, and increases abnormal morphology. Another study found an inverse relationship between erectile dysfunction and quality of life measured through the fertility quality of life tool (FertiQoL) and a significant relationship between depression and erectile dysfunction. Additionally, a prospective study suggested infertile men are generally less healthy than their fertile counterparts when considering overall health.
It is unclear whether psychological interventions would be helpful to infertile males; a meta-analysis found a non-significant relationship regarding psychological interventions and depressive symptoms and anxiety in men from infertile couples. However, a systematic review found cognitive behavioral therapy and mind-body interventions proved to be effective psychological interventions, with some positive effects on anxiety, pregnancy rates or marital function, and that coping therapy may be used to reduce stress and anxiety in the waiting period before the pregnancy test.
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