Women's perceptions and experiences of the challenges in the process of male infertility treatment

A qualitative study

Authors

  • Fatemeh Zahra Karimi Ph.D., Assistant Professor of Reproductive Health, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Keywords:

Male Infertility; Women; Treatment Challenges; Qualitative Study; Perception; Experiences

Abstract

Background: Despite the fact that both men and women are equally subject to infertility, it is usually women who bear the burden of treatment and its consequences, even in cases of male infertility. Therefore, it is more necessary to recognize their health problems in order to help them. 

Aim: To explore women's perceptions and experiences of the challenges they face in the process of male infertility treatment. 

Methods: This qualitative study was conducted during 2014-2015 using content analysis. Thirty semi-structured interviews were conducted with women whose husbands suffered from male infertility. Purposive sampling was conducted until data saturation was achieved. All interviews were recorded, transcribed and analyzed using conventional content analysis adopted by Graneheim and Lundman. 

Results: From data analysis, the major category of “treatment-related stresses” and four subcategories of “high treatment expenses”, “inefficiency of healthcare system”, “being captive in the infertility treatment” and “treatment failure” emerged. 

Conclusion: Experiences of women who face male infertility indicate their various concerns in the process of treatment. Therefore, it is required to develop emotional and financial support for the clients and to promote their quality of healthcare services. In addition, awareness of treatment challenges of these women can assist proper planning to promote the quality of services they need.

References

Ferlin A, Raicu F, Gatta V, Zuccarello D, Palka G, Foresta C. Male infertility: role of genetic background.

Reprod Biomed Online. 2007; 14(6): 734-45. doi: 10.1016/S1472-6483(10)60677-3. PMID: 17579990.

Smith JF, Walsh TJ, Shindel AW, Turek PJ, Wing H, Pasch L, et al. Sexual, marital, and social impact of a

man's perceived infertility diagnosis. J Sex Med. 2009; 6(9): 2505-15. doi: 10.1111/j.1743- 6109.2009.01383.x. PMID: 19619144, PMCID: PMC2888139.

Lipshultz LI, Howards SS, Niederberger CS. Infertility in the Male: Cambridge University Press; 2009.

Krausz C. Male infertility: pathogenesis and clinical diagnosis. Best Pract Res Clin Endocrinol Metab.

; 25(2): 271-85. doi: 10.1016/j.beem.2010.08.006. PMID: 21397198.

Poongothai J, Gopenath TS, Manonayaki S. Genetics of human male infertility. Singapore Med J. 2009;

(4): 336-47. PMID: 19421675.

Sadeghian E, Heidarian-poor A, Abed F. Comparison of psychiatric problems in infertile men and women

referring to infertility clinic of Hamadan Fatemyeh Hospital. Journal of Arak University of Medical

Sciences. 2006; 9(2): 31-9.

Jaffe RB. The Risk of Major Birth Defects After Intracytoplasmic Sperm Injection and in Vitro

Fertilization. N Engl J Med. 2002; 57(8): 517-8. doi: 10.1056/NEJMoa010035.

Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;

(2): 293-308. doi: 10.1016/j.bpobgyn.2006.12.003. PMID: 17241818.

Taghvi N, Fathi Ashtiyani A. A Comparison between Psychological Features of Fertile and Infertile

Individuals. Thought and Behavior in Clinical Psychology. 2009; 3(11): 45-54.

Gourounti K, Anagnostopoulos F, Potamianos G, Lykeridou K, Schmidt L, Vaslamatzis G. Perception of

control, coping and psychological stress of infertile women undergoing IVF. Reprod Biomed Online. 2012;

(6): 670-9. doi: 10.1016/j.rbmo.2012.03.002. PMID: 22503340.

Martins MV, Peterson BD, Almeida VM, Costa ME. Direct and indirect effects of perceived social support

on women's infertility-related stress. Hum Reprod. 2011; 26(8): 2113-21. doi: 10.1093/humrep/der157.

PMID: 21596709.

Younesi SJ, Akbari-Zardkhaneh S, Ardekani ZB. Evaluating stigma among infertile men and women in

Iran. Journal of Reproduction & Infertility. 2006; 6(5): 531-45.

Dyer SJ, Abrahams N, Hoffman M, van der Spuy ZM. Infertility in South Africa: women's reproductive

health knowledge and treatment-seeking behaviour for involuntary childlessness. Hum Reprod. 2002;

(6): 1657-62. doi: 10.1093/humrep/17.6.1657. PMID: 12042294.

Tabong PT, Adongo PB. Infertility and childlessness: a qualitative study of the experiences of infertile

couples in Northern Ghana. BMC Pregnancy Childbirth. 2013; 13(1): 72. doi: 10.1186/1471-2393-13-72.

PMID: 23517021, PMCID: PMC3610195.

Dyer SJ, Abrahams N, Hoffman M, van der Spuy ZM. 'Men leave me as I cannot have children': women's

experiences with involuntary childlessness. Hum Reprod. 2002; 17(6): 1663-8. doi:

1093/humrep/17.6.1663. PMID: 12042295.

Polit DF, Beck CT. Essentials of nursing research: Appraising evidence for nursing practice. United States:

Lippincott Williams & Wilkins. 2013.

Gibson DM, Myers JE. Gender and infertility: A relational approach to counseling women. Journal of

Counseling & Development. 2000; 78(4): 400-10. doi: 10.1002/j.1556-6676.2000.tb01923.x.

Lee TY, Sun GH, Chao SC. The effect of an infertility diagnosis on the distress, marital and sexual

satisfaction between husbands and wives in Taiwan. Hum reprod. 2001; 16(8): 1762-7. doi:

1093/humrep/16.8.1762. PMID: 11473979.

Hosseini FM, Farzadi L, Fatemi NS. Tense factors and coping strategies in infertile women referring to

Alzahra Training Clinical Center of Tabriz (1998). Journal of Reproduction & Infertility. 2001; 2(3): 27-34.

Meng MV, Greene KL, Turek PJ. Surgery or assisted reproduction? A decision analysis of treatment costs

in male infertility. J Urol. 2005; 174(5): 1926-31. doi: 10.1097/01.ju.0000176736.74328.1a. PMID: 16217347.

Mohammadi MR, Farahani FKA. Emotional and psychological problems of infertility and strategies to

overcome them. Journal of Reproduction & Infertility. 2001; 2(4): 33-9.

Rodriguez D. Female fertility: a conceptual and dimensional analysis. J Midwifery Womens Health. 2013;

(2): 182-8. doi: 10.1111/j.1542-2011.2012.00234.x. PMID: 23458691.

Salmela-Aro K, Suikkari AM. Letting go of your dreams-Adjustment of child-related goal appraisals and

depressive symptoms during infertility treatment. Journal of Research in Personality. 2008; 42(4): 988- 1003. doi: 10.1016/j.jrp.2008.02.007.

Fahami F, Hosseini GS, Ehsanpour S, Zargham A. Women’s lived experiences of female infertility. Iranina

Journal of Obstetrics Gynecology and Infertility. 2010; 4(30): 45-53.

Roudsari RL, Allan HT. Women’s experiences and preferences in relation to infertility counselling: a

multifaith dialogue. International journal of fertility & sterility. 2011; 5(3): 158-67. PMID: 25101160,

PMCID: PMC4122831.

Mascarenhas MN, Cheung H, Mathers CD, Stevens GA. Measuring infertility in populations: constructing

a standard definition for use with demographic and reproductive health surveys. Popul Health Metr. 2012;

(1): 17. doi: 10.1186/1478-7954-10-17. PMID: 22938182, PMCID: PMC3511253.

Savadzadeh S, Madadzadeh N. Explanation of Emotional Feelings of Women with Infertility: A Qualitative

Study. Journal of Ilam University of medical sciences. 2013; 21(2): 16-24.

Karimi FZ, Taghipour A, Roudsari RL, Kimiaei SA, Mazlom SR, Amirian M. Cognitive emotional

consequences of male infertility in their female partners: a qualitative content analysis. Electronic

physician. 2015; 7(7): 1449-57. doi: 10.19082/149. PMCID: PMC4700889.

Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major birth defects after intracytoplasmic sperm

injection and in vitro fertilization. N Engl J Med. 2002; 346(10): 725-30. doi: 10.1056/NEJMoa010035.

PMID: 11882727.

Younesi SJ, Salagegheh A. Body image in fertile and infertile women. Journal of Reproduction &

Infertility. 2001; 2(4): 14-21.

Mumtaz Z, Shahid U, Levay A. Understanding the impact of gendered roles on the experiences of

infertility amongst men and women in Punjab. Reprod Health. 2013; 10(3): 2-10. doi: 10.1186/1742-4755- 10-3. PMID: 23317173, PMCID: PMC3562138.

Karimi FZ, Taghipour A, Roudsari RL, Kimiaei SA, Mazlom SR, Amirian M. Psycho - social effects of

male infertility in Iranian women: a qualitative study. IJOGI. 2016; 19(10):20-32. DOI):

22038/ijogi.2016.7111

Heidari P., Latifnejad Roudsari R. Relationship betwenn psycosocial factors and marital satisfaction in

infertile women, Journal of Ghazvin University of Medical Sciences, 2010; 14 (1): 26-32

Latifnejad Roudsari R, Allan H, Smith P. A Qualitative Inquiry into the Mediating Role of Religion and

Spirituality in Adjusting Marital Relationships of Infertile Women. Journal of Midwifery and Reproductive

Health. 2013; 1(1): 33-41.

Karimi FZ, Taghipour A, Roudsari RL, Kimiaei SA, Mazlom SR, Amirian M. Social aspects of male

infertility: the perceptions and experiences of Iranian women. J Reprod Infertile.2016;17 (Suppl 2): 79

Behdani F, Erfanian M, Hebrani P, Hojat SK. Prevalence of depression and related factors in infertile

women. J Fundam Ment Health. 2004; 6(23-24): 141-6.

Abbasi-Shavazi MJ, Nasrabad HBR, Ardekani ZB, Akhondi MM. Attitudes of infertile women towards

gamete donation: a case study in Tehran. Journal of Reproduction & Infertility. 2006; 7(2): 139-48.

Published

2022-01-18

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