Male Infertility: Taboo or Fear of Judgement - A Cross-Sectional Study from A Rural Tertiary Care Hospital

Abstract

Background: Male infertility remains under-recognized in many low- and middle-income settings, where gender norms, stigma, limited awareness, and fear of social judgement may discourage men from participating in infertility evaluation and treatment. This study assessed men’s awareness, perceptions, attitudes, and health-seeking behaviour regarding male infertility in a rural tertiary-care setting.

Methods: A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Sri Adichunchanagiri Hospital and Research Centre, B.G. Nagara. Fifty men aged 20–50 years, who were partners of couples attempting conception, were enrolled. Data were collected using a structured questionnaire comprising closed- and open-ended questions, supplemented by in-depth interviews and focus group discussions.

Results: The mean age of male participants was 35.94 ± 5.07 years, and couples had been attempting conception for a mean duration of 5.5 ± 3.84 years. Although 62% of participants recognized that infertility could be attributable to the male partner, 38% continued to attribute infertility primarily to women, while 60% believed that women bear a greater burden of responsibility. Despite prolonged infertility, 74% of men had never undergone evaluation and 96% had not received treatment. Limited visibility of support systems, persistent gender bias, cultural conditioning, and fear of social judgement were important barriers to appropriate health-seeking behaviour.

Conclusion: Male infertility continues to be surrounded by stigma despite partial awareness of the male contribution to infertility. Persistent gender-based perceptions and delayed male evaluation highlight the need for improved reproductive-health education, couple-based counselling, early male involvement in infertility assessment, and accessible psychosocial support in rural healthcare settings.