Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Distress in Infertile Males in Manipal-India: A Clinic Based Study

Authors
Ansha Patel 1
Podila Venkata Narasimha Sharma 1
Pratapkumar Narayan 2
Binu Sreekumaran Nair 3
Dinesh Narayanakurup 4
Praveena Pai 5
1 Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, India
2 Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, India; Division of Assisted Reproductive Centre, Kasturba Medical College, Manipal University, Manipal, India
3 Department of Statistics, Manipal University, Manipal, India
4 Department of Clinical Psychology, School of Allied Health Sciences, Manipal University, Manipal, India
5 Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, India
Abstract
Background: Being infertile comes as an overwhelming realization for couples trying to conceive. In consideration of rising rates of infertility worldwide, clinicians in India have also begun exploring this field for new possibilities, development and research. The purpose of this study was to estimate the proportion and predictors of infertility specific stress in males diagnosed with primary infertility. Methods: This cross-sectional research was conducted in an assisted reproduction center, Manipal, India, on 300 infertile married males. The tools were "semi-structured questionnaire" compiled by the authors, "ICD-10 Classification of Mental and Behavioural Disorders (Clinical Descriptions and Diagnostic Guidelines) and" Psychological Evaluation Test for infertility. Multiple logistic regression analysis was carried out on data with p-value fixed as 0.05. Results: The presence of stress was reported in 72% of male participants. The predictors of stress were nature and severity of their infertility diagnosis, sperm defects, urological condition and experience of corrective surgery undergone for it. Psychological stress in men was also predicted by present and past history of significant psychiatric morbidity and coping difficulties associated with it. Conclusion: The stress is both a common experience and at times a clinical condition associated with deteriorating mental and physical health in men seeking fertility treatments. As a prerequisite, Indian fertility clinics need to treat stress as an identifiable condition and devise ways of addressing it at all stages of assisted conception and reproductive treatments.
Keywords
Cross
sectional study
India
Infertility
Male
Morbidity
Psychological factors
Stress
  1. Dunkel-Schetter C, Stanton AL, editors. Infertility: Perspectives from stress and coping research. 1st ed. New York: Plenum; 1991. Chapter 10, Psychological adjustment to infertility: Future directions in research and application; p. 197-222.
  2. Read J. Counselling for Fertility Problems. London: Sage Publications Ltd; 1985.
  3. Diamond R, Kezur D, Meyers M, Scharf CN, Weinschel M. Couple therapy for infertility. 1st ed. New York: Guilford Press; 1999. 243 p.
  4. Ulbrich PM, Coyle AT, Llabre MM. Involuntary childlessness and marital adjustment: his and hers. J Sex Marital Ther. 1990;16(3):147-58.
  5. Wright J, Duchesne C, Sabourin S, Bissonnette F, Benoit J, Girard Y. Psychosocial distress and infertility: men and women respond differently. Fertil Steril. 1991;55(1):100-8.
  6. Harvey JH. Disenfranchised grief: New directions, challenges, and strategies for practice. 1st ed. Champaign, IL: Research Press; 2002. p.17-22.
  7. Guerra D, Llobera A, Veiga A, Barri PN. Psychiatric morbidity in couples attending a fertility service. Hum Reprod. 1998;13(6):1733-6.
  8. Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundström Poromaa I. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod. 2008;23(9):2056-63.
  9. Berger DM. Impotence following the discovery of azoospermia. Fertil Steril. 1980;34(2):154-6.
  10. Feuer GS. The psychological impact of infertility on the lives of men. Diss Abstr Int. 1983;44(3-A):706-7.
  11. Rogstad KE. The psychological effects of vasectomy. Sex Marital Ther. 1996;11(3):265-72.
  12. Burns LH, Covington SN. Infertility Counseling: A Comprehensive Handbook for Clinicians. 1st ed. New York: Parthenon; 1999. Chapter 18, Recipient counselling for donor insemination; p. 325-44.
  13. Irvine S, Cawood E. Male infertility and its effect on male sexuality. Sex Marital Ther. 1996;11(3):273-80.
  14. Dhillon R, Cumming CE, Cumming DC. Psychological well-being and coping patterns in infertile men. Fertil Steril. 2000;74(4):702-6.
  15. Kedem P, Mikulincer M, Nathanson YE, Bartoov B. Psychological aspects of male infertility. Br J Med Psychol. 1990;63(1):73-80.
  16. Glover L, Hunter M, Richards JM, Katz M, Abel PD. Development of the fertility adjustment scale. Fertil Steril. 1999;72(4):623-8.
  17. Endler A,Liebig J, Hölldobler B. Queen fertility, egg marking and colony size in the ant Camponotus floridanus. Behavioral Ecology and Sociobiology. 2006;59(4):490-9.
  18. Terry DJ, Hynes GJ. Adjustment to a low-control situation: Reexamining the role of coping responses. J Pers Soc Psychol. 1998;74(4):1078-92.
  19. Berghuis JP, Stanton AL. Adjustment to a dyadic stressor: a longitudinal study of coping and depressive symptoms in infertile couples over an insemination attempt. J Consult Clin Psychol. 2002;70(2):433-8.
  20. World Health Organization. The ICD-10 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. 2nd ed. Geneva: World Health Organization; 2004. p. 65-135.
  21. Franco JG Jr, Razera Baruffi RL, Mauri AL, Petersen CG, Felipe V, Garbellini E. Psychological evaluation test for infertile couples. J Assist Reprod Genet. 2002;19(6):269-73.
  22. Wiersema NJ, Drukker AJ, Mai BT, Giang HN, Nguyen TN, Lambalk CB. Consequences of infertility in developing countries: results of a questionnaire and interview survey in the South of Vietnam. J Transl Med. 2006;4:54.
  23. Olshansky EF. Infertility and its influence on women's career identities. Health Care Women Int. 1987;8(2-3):185-96.
  24. Leon IG. Understanding and treating infertility: psychoanalytic considerations. J Am Acad Psychoanal Dyn Psychiatry. 2010;38(1):47-75.
  25. Kikendall KA. Self-discrepancy as an important factor in addressing women's emotional reactions to infertility. Prof Psychol: Res Pract. 1994;25(3):214-20.
  26. Gerrity DA. A biopsychosocial theory of infertility. Fam J. 2001;9(2):151-8.
  27. Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293-308.
  28. Webb RE, Daniluk JC. The end of the line infertile men's experiences of being unable to produce a child. Men Masc. 1999;2(1):6-25.
  29. Freeman EW, Boxer AS, Rickels K, Tureck R, Mastroianni L Jr. Psychological evaluation and support in a program of in vitro fertilization and embryo transfer. Fertil Steril. 1985;43(1):48-53.
  30. Berger DM. Couples' reactions to male infertility and donor insemination. Am J Psychiatry. 1980;137(9):1047-9.
  31. Gannon K, Glover L, Abel P. Masculinity, infertility, stigma and media reports. Soc Sci Med. 2004;59(6):1169-75.
  32. Becker G, Nachtigall RD. Eager for medicalisation: the social production of infertility as a disease. Sociol Health Illn. 1992;14(4):456-71.
  33. Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Köhn FM, Schroeder-Printzen I, et al. Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI. Andrologia. 1999;31(1):27-35.
  34. Wichman CL, Ehlers SL, Wichman SE, Weaver AL, Coddington C. Comparison of multiple psychological distress measures between men and women preparing for in vitro fertilization. Fertil Steril. 2011;95(2):717-21.
  35. Daniluk J. Helping patients cope with infertility. Clin Obstet Gynecol. 1997;40(3):661-72.
  36. McGrady AV. Effects of psychological stress on male reproduction: a review. Arch Androl. 1984;13(1):1-7.
  37. Lenzi A, Lombardo F, Salacone P, Gandini L, Jannini EA. Stress, sexual dysfunctions, and male infertility. J Endocrinol Invest. 2003;26(3 Suppl):72-6.
  38. Nene UA, Coyaji K, Apte H. Infertility: a label of choice in the case of sexually dysfunctional couples. Patient Educ Couns. 2005;59(3):234-8.
  39. Bharadwaj A. Why adoption is not an option in India: the visibility of infertility, the secrecy of donor insemination, and other cultural complexities. Soc Sci Med. 2003;56(9):1867-80.
  40. Jejeebhoy SJ. Infertility in India-levels, patterns and consequences: Priorities for social science research. J Fam Welf. 1998;44(2):15-24.
  41. Thara R, Ramachandran V, Hassan PP. Psychological aspects of infertility. Indian J Psychiatry. 1986;28(4):329-34.
  42. Tao P, Coates R, Maycock B. The impact of infertility on sexuality: A literature review. Australas Med J. 2011;4(11):620-7.
  43. Collodel G, Moretti E, Fontani V, Rinaldi S, Aravagli L, Saragò G, et al. Effect of emotional stress on sperm quality. Indian J Med Res. 2008;128(3):254-61.
Journal of Reproduction & Infertility
Volume 17, Issue 4
Autumn 2016
Pages 213-220