'You are a man because you have children': experiences, reproductive health knowledge and treatment-seeking behaviour among men suffering from couple infertility in South Africa

TLDR

In Africa, infertility has traditionally been viewed as a female problem. This study investigates men’s reproductive health knowledge, health‑seeking behavior, and experiences of involuntary childlessness in the context of couple infertility. Twenty‑seven men from a culturally diverse urban community in South Africa were interviewed during their first visit to a tertiary infertility clinic. Men had limited knowledge of fertility physiology, causes, and treatments, yet were aware of male factor infertility, actively engaged in care, and reported emotional distress, marital strain, stigma, and loss of social status, highlighting the need for counseling and community education to better integrate men into infertility management.

Abstract

BACKGROUND: In Africa, infertility traditionally has been viewed as a female problem. This study explores reproductive health knowledge, health‐seeking behaviour and experiences related to involuntary childlessness in men suffering from couple infertility. METHODS: Twenty‐seven men from a diverse cultural urban community in South Africa participated in in‐depth interviews at the time of their first visit to an infertility clinic in a tertiary referral centre. RESULTS: Men had little knowledge about the physiology of human fertility, causes of infertility and modern treatment options. Awareness of male factor infertility was, however, high. Most men appeared involved in the health‐seeking process. Men described their emotional reactions to childlessness and the impact of infertility on marital stability, and many reported that infertile men suffered from stigmatization, verbal abuse and loss of social status. CONCLUSIONS: These findings improve our understanding of the reproductive health needs of men suffering from couple infertility in Africa. This understanding is essential for the effective integration of male partners into modern infertility management. The need for appropriate counselling of men and, most particularly, for education of the community is recognized.