Attitudes Toward Masculinity Keep Men From Accessing Infertility Support, Treatment
Devraj Hazarika and his wife have been married for more than seven years, and they have been trying to conceive for the last two years. After a few futile attempts, they found out that Hazarika had a low sperm count. “What if my wife leaves me because I can’t give her a child?” Hazarika, 36, recalls wondering.
He did what men are asked to do by fertility experts: He started taking vitamins and antioxidants, and exercising. But his sperm count did not go up. So, his doctor advised the couple to pursue in vitro fertilization (IVF), a procedure in which an egg and sperm sample are collected from the couple, and the egg is fertilized by a sperm outside the body, in a petri dish.
During that time, Hazarika sought emotional support from his family and friends, but many didn’t know how to react. The fact that men’s fertility issues are not openly talked about left him feeling unsupported. It is very common for a man diagnosed with infertility to feel emotionally isolated, said Dr. Aditi Dani, a fertility consultant at Mumbai’s Masina Hospital. “People don’t talk about male infertility as much because of its association with male virility and sexual potency,” she said.
In its latest report on the status of infertility in India, the World Health Organization stated that out of all infertility cases, approximately 50% are due to ‘male factors’. “Their sperm might have a low count; they may have a lot of abnormal sperm … the sperm might not be moving well … and men above 40 might have a lower chance of having a child than people who are younger,” said Dr. Dani.
While data reveals that fertility problems are equally likely in both men and women, most fertility treatments and discussions revolve around the woman’s experience. “They’re the ones going through the physical trouble of undergoing these treatments, along with bearing an intrinsically patriarchal society,” said Dr. Dani. “I have often come across cases where men exhibit a reluctance to acknowledge that the issue could exist in them.”
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In a study titled, “‘It’s Different for Men’: Masculinity and IVF,” authors Karen Throsby and Rosalind Gill discuss what they see as the influence of “hegemonic masculine culture on spousal relations … husbands feel that infertility threatens their masculinity; while wives are pitied, husbands are teased.” Men respond, according to Throsby and Gill, by casting blame on their wives.
Dr. Shilpa Agarwal, consultant, obstetrics and gynecology at Mumbai’s Jaslok Hospital and Research Centre, said men’s reluctance to get their semen checked is fairly common among city dwellers, and much worse among people who come for treatment from rural areas. She said many women walk in, along with their in-laws or husbands, all of them with preconceived notions — due to lack of knowledge and traditional societal beliefs — that the problem lies in the woman; it could not possibly be because of their husbands.
Both fertility experts interviewed said when a couple complains they haven’t been able to conceive, the first step they take is to ask the couple to rule out the ‘male factor’ through a semen sample test. Sperm issues doesn’t come out in the open otherwise, Dr. Dani said.
Hazarika said he’s never blamed his wife for their difficulty conceiving, but he admitted to feeling shaken after having to resort to IVF. “It felt like I had lost my masculinity,” he said. Now, he has his own advice for men who are also dealing fertility struggles. He said the best way to deal with this kind of “lost identity” is to be there for your wife, talk about what’s going on instead of suppressing your emotions, and reach out to counselors, health and fertility experts, and family and friends for support.
“There needs to be more awareness in society that infertility could be as much a man’s issue as it is that of a woman’s, and there is nothing wrong with that. It is as simple as something in our bodies not functioning well, which isn’t really in our hands, but can be fixed with proper and more informed processes,” he said.