Volume 25, Issue 4 (July 2023) 25, 448–453; 10.4103/aja202282
Psychological, social, and sexual challenges affecting men receiving male infertility treatment: a systematic review and implications for clinical care
Winston Wu1, Justin La2, Kathryn M Schubach3, Daniel Lantsberg3,4,5, Darren J Katz1,3,6
1 Department of Urology, Western Health, St Albans, VIC 3021, Australia 2 Department of Urology, Kaiser Permanente San Rafael Medical Center, San Rafael, CA 94903, USA 3 Men's Health Melbourne, Melbourne, VIC 3000, Australia 4 Reproductive Services Unit, The Royal Women's Hospital, Parkville, VIC 3052, Australia 5 Melbourne IVF, East Melbourne, VIC 3002, Australia 6 Department of Surgery, Western Precinct, University of Melbourne, Parkville, VIC 3010, Australia
Correspondence: Dr. W Wu (wenchenw1@gmail.com)
Date of Submission 05-May-2022 Date of Acceptance 19-Sep-2022 Date of Web Publication 11-Nov-2022
Abstract |
In recent years, social research surrounding the consequences of infertility has increasingly focused on the male perspective; however, a gap exists in the understanding of men's experiences of male infertility treatment. This review aims to synthesize the existing evidence concerning the psychological, social, and sexual burden of male infertility treatment on men, as well as patient needs during clinical care. A systematic search identified 12 studies that are diverse in design, setting, and methods. Psychological evaluations have found that urological surgery may have a lasting impact on infertility-specific stress, and treatment failure can lead to feelings of depression, grief, and inadequacy. Men tended to have an avoidant coping mechanism throughout fertility treatment, and their self-esteem, relationship quality, and sexual functions can be tied to outcomes of treatment. Partner bonds can be strengthened by mutual support and enhanced communication; couple separation, however, has been noted as a predominant reason for discontinuing male infertility treatment and may be associated with difficult circumstances surrounding severe male infertility. Surgical treatments can affect the sexual functioning of infertile men; however, the impact of testicular sperm extraction outcomes appears to be psychologically driven whereas the improvements after microsurgical varicocelectomy are only evident in hypogonadal men. Clinically, there is a need for better inclusion, communication, education, and resource provision, to address reported issues of marginalization and uncertainty in men. Routine psychosocial screening in cases of severe male infertility and follow-up in cases of surgical treatment failure are likely beneficial.
Keywords: male infertility; male infertility treatment; patient experience; patient-centered care; psychosocial; sexual
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