It’s not her, it’s me - the deafening silence of male infertility
How often have you heard the words “it’s not her, it’s me” in social conversations related to an infertility journey? Sometimes? Rarely? Often?
I certainly haven’t…..ever!
And I have been in this community of #IVFwarriors and #childlesspeople for a long time.
Male factor infertility accounts for about 30% of the couples who are on an IVF journey (source: monashivf.com). Some researchers state male factor infertility may even account for anywhere between 20% - 70% of couples seeking treatment*.
And yet, there is shortage of research and conversations about the impact of male infertility on the wellbeing of men or on the couple’s relationship.
In fact, I would even say the silence surrounding male infertility is deafening. It appears to be the elephant in the suitcase, not the room, in the suitcase – packed away and hidden from most.
While there has been much conversation and research into the psychological and social aspects of infertility in women, the psychosocial consequences of infertility for men are less well understood.
Dr Robin Hadley, leading expert on the impact of male childlessness states “data on men who do not become fathers has been excluded and their experiences minimized and dismissed. Infertility research has shown that failure to achieve the high social status of parenthood has the similar effects on mental and physical health as a diagnosis of life-threatening illness”. This is serious stuff. So why is there so little information, data, research, or general conversation around this topic?
The reasons are wide and varied. The most common is that men rarely share as deeply and transparently as women do about the many and varied emotions infertility brings up. The other aspect not spoken about is the blame and shame taken on in the mind of infertile men. They say they feel guilty and responsible for the various invasive procedures and stresses the woman must go through for them to be able to conceive a child. And these feelings of guilt are more pronounced if the woman has no medical issues preventing natural conception.
“My partner can’t get pregnant because of me and now she has to endure all these medical procedures, will she resent me?” is a common thought. For some fear also creeps in – “does my partner still see me in the same way? Will this news end our relationship? What will people think of me if they find out?” In some cultures, men are even encouraged to stay silent about their infertility to “save face” not only theirs but also the family’s.
There is definitely a lack of social narrative around infertility for men to relate to, and this “something missing” is a significant reason for the disenfranchised grief that so many experience.
In a society that widely equates virility with fertility, the silence only serves to compound feelings of reduced self-esteem, guilt, fear, inadequacy, questions around identity and masculinity, deep sadness about loss of lineage ie no one to carry on the bloodline, and a range of other emotions.
A couple’s infertility journey tends to focus on the woman. She is the one going through the procedures, so it is not surprising that most of the research and psychosocial support is focused on the woman.
The man’s participation in the long and arduous process is minimal or one could even say ends with the sperm donation. Some men have stated they feel “un-needed, unwanted, and surplus to requirements” post sperm donation.
In my work, I also find that most men tend to take on the role of “provider-protector” and all the attention and energy is on the woman’s wellbeing throughout the process and especially when there are losses no matter at which stage. We often forget in miscarriages – he lost a baby also. The same applies for embryo losses. He has lost his dreams and hopes just as much as the woman has.
If the treatments end without a liveborn take home baby, there may be a sense of “I put my partner/ wife through all of that for nothing”, which in some cases outweigh any feelings of his own loss and grief over their shared future dreams.
Psychosocial support for infertile men’s wellbeing is crucial and needs to be addressed in more definite terms. We need to be supporting men to #breakthesilence about the impacts of male infertility on all dimensions of life.
So how does a man who is grappling with infertility look after himself?
Firstly, it is important to identify and acknowledge the multitude of emotions he may be going through. Sometimes, we don’t have the words to be able to articulate what is going on for us. Remember grief is complex and more than just sadness – there are a range of emotions that accompany grief – anger, jealousy, anxiety to name a few. Which of these is impacting you or inhibiting normal functioning? This is where speaking with a therapist may be useful in having some help to unpack feelings and find the words so that they can then be addressed.
Second grief which is kept hidden is disenfranchised grief which can lead to isolation, increased stigmatization, and sometimes a more prolonged and intense grieving process. It is difficult to heal what is being kept intentionally hidden. A therapist can help bring to the surface what it hidden and in doing so provide a safe container to address these thoughts, feelings, and behaviors.
Third, recognizing the myriads of factors not visible to others that he may want and need a safe space to process. These could be relationship issues, identity, secondary losses…. There may be specific activities or rituals that may be helpful. Just as doing weights helps build muscles, therapists can help build grief muscles and your own unique toolkit to carry what can’t be fixed.
It is important to remember and be aware that each and every one of us has an “iceberg” of feelings, thoughts, and behaviors that relate to our individual IVF journeys. There are things that are above the surface that are seen and may be supported, and there are many more items below the surface that are hidden but could still be impacting wellbeing.
What does your iceberg look like? Do you need a safe confidential space to explore if and how these are impacting your wellbeing, identity, and relationships?
Is there an elephant in the suitcase hidden in plain sight of your relationship but ignored because it is easier?
If you have read this far, thank you. Please know that you are not alone, you are not broken, you are not less. Working with a therapist who understands male infertility is important to help you help yourself to heal, to create your own unique identity, to build grief muscles.
Please reach out for an obligation free conversation if you would like a safe space to share thoughts and feelings.
References:
* de Vries, C.E.J., Veerman-Verweij, E.M., van den Hoogen, A. et al. The psychosocial impact of male infertility on men undergoing ICSI treatment: a qualitative study. Reprod Health 21, 26 (2024). https://doi.org/10.1186/s12978-024-01749-6
Hadley, Robin (2024) Muted voices of invisible men: the impact of male childlessness. In: Work-Life Inclusion: Broadening Perspectives Across the Life-Course. Emerald Publishing Lim ited, Leeds, pp. 135-146. ISBN 9781803822204 (print); 9781803822198 (ebook) DOI: https://doi.org/10.1108/978-1-80382-219-820241011 Downloaded from: https://e-space.mmu.ac.uk/635327
Fisher, J. R. W., & Hammarberg, K. (2012). Psychological and social aspects of infertility in men: An overview of the evidence and implications for psychologically informed clinical care and future research. Asian Journal of Andrology, 14, 121 - 129. https://doi.org/10.1038/aja.2011.72
More info on men and childlessness (not all of these relate to infertility)
Robin Hadley – Investigating the complexities of male childlessness - https://www.robinhadley.co.uk/
Podcast - 26 Robin Hadley: Men and the impact of childlessness — Andrew Pain - https://www.andrewpain.co.uk/podcast/s1-e26-robin-hadley
#lifeafterivf #griefsupport #grieftherapy #childlessnotbychoice #whoami #lifeafterivfau #youarenotalone #SelfCare #ChildlessNotByChoice #EmotionalWellbeing #CopingWithChildlessness #Resilience #JoyfulLiving #HealingJourney #IVFRollercoaster #CompassionateSelfTalk #BuildingResilience #NurtureYourself #cnbc, #ICSI, #growingthroughgrief, #lossparents, #failedcycles, #livingwithchildlessness, #twodads, #embryoloss, #tonkinsmodelofgrief #hopeandhealing #wellbeing #notalone #ICSI #maleinfertility #childlessmen #menswellbeing #twodads #notadad #babyinmyheart #mensgriefmatters #unspokengrief #hiddengrief #amiaman #infertilityawareness #IVFwarrior #infertilityjourney
Image created by ChatGPT from original prompt by AAltamore June 2025