Introduction

Infertility has predominantly been viewed as a female infliction (Menning, 1988). In some cultures, when a couple is unable to conceive the man may be granted a divorce so he can remarry, on the basis of the automatic assumption of female factor infertility (Greil, 1991). The notion that the problem might originate in man is not even entertained. In our own culture, most infertility research has focused on the female reproductive system, resulting in a greater array of diagnostic and treatment alternatives for women than for men (Office of Technology Assessment, 1988). Yet, approximately 35% of infertile couples have trouble conceiving due to male factor infertility and another 20% due to combined male and female factor problems (Menning, 1988). In this chapter we will first address the societal context of male infertility and masculinity, then discuss gender and couple patterns of distress and treatment, how health care professionals can reduce the shame response, secrecy in donor insemination, and male sexual dysfunction.

The male response to infertility

Historically and across cultures, there has been difficulty in accepting the existence of male infertility. The individual and collective denial of male factor infertility may occur for a variety of reasons. Since it takes two to create a pregnancy, the assumption of who is defective may be guided by which gender is easier to label as abnormal. Historically, women have been viewed as being less valuable, less intelligent, and less capable in our male-dominated society (Tavris, 1992).