Parenthood might be a cherished dream for many couples, but it is beset by its unique set of hurdles. Infertility is one such challenge that is a significant concern today for many adults, affecting their ability to conceive. Infertility impacts approximately one in every six couples who are attempting to start a family and in at least half of these cases, male factors are the contributing cause.
The Week speaks to Diana Crasta, Chief Psychological Counsellor, Nova IVF Fertility, on the corelation between mental health and infertility.
Excerpts:
What is male infertility, and how is it defined medically?
Infertility refers to the complications within the reproductive system that hinder a couple's conception process. Typically, if a male and female engage in regular, unprotected sexual intercourse for a year or more, and pregnancy does not occur, it raises the concern about potential fertility issues. Male infertility can stem from several factors, with issues related to sperm delivery and sperm quality being among the most significant. To be fertile, a man's sperm should be healthy, exhibit good quality, and have a sperm count within the average range. If any of these aspects are lacking or compromised, it may lead to male infertility. Research indicates that approximately one-third of infertility cases are attributed to the factors related to males. This underscores the importance of recognising and addressing male infertility as a significant factor for couples battling infertility.
What are some primary causes of male infertility?
Certain lifestyle choices such as irregular dietary patterns, poor sleep schedule, substance abuse, radiation exposure, consumption of steroids and over-exercise as well as factors such as decreased sperm quality, low testosterone levels and increased age are catalysts for fertility issues in men. Conditions such as Azoospermia (no sperm to ejaculate), Varicoceles (enlargement of the veins that transport oxygen-depleted blood away from the testicle), Oligospermia (low sperm count) lead to male infertility. However, advanced fertility solutions such as IVF, ICSI and sperm freezing have emerged to address these challenges and assist couples in their journey towards parenthood.
How can stress and mental health issues impact one’s fertility?
Mental well-being and fertility problems go hand in hand, influencing one another in various ways. Stress can lead to the release of steroid hormones like glucocorticoids, which have the potential to lower testosterone levels and inhibit sperm production. Oxidative stress (low anti-oxidant levels) is another factor that can negatively affect semen quality and fertility. Additionally, conditions like anxiety and depression can contribute to various forms of sexual dysfunction. For example, a strong link exists between depression and a decrease in libido.
A recent study found that individuals with major depression were 60 per cent likely to achieve a live birth compared to those without major depression. There are numerous potential factors associated with male depression that can interfere with fertility such as reduced libido, erectile dysfunction, delayed or inhibited ejaculation, a decrease in the frequency of sexual intercourse, or even adverse changes in sperm quality. In addition, societal norms and stereotypes have compelled men from opening up about their struggles.
Moreover, issues related to sexual function in men, like erectile dysfunction or diminished libido, have the potential to create tension within intimate relationships, leading to conflicts and decreased emotional connection.
What are the mental health challenges faced by couples undergoing IVF?
According to recent studies, the inability to conceive can lead to mental health issues such as stress, anxiety, and depression in both women and men. Couples who opt for IVF (In-Vitro Fertilisation) often grapple with feelings of stress, guilt, and low self-confidence. They may perceive themselves as failures, and the demanding nature of IVF treatment only adds to their emotional burden.
Moreover, these fertility challenges can strain relationships, leading to conflicts, misunderstandings, and a decrease in intimacy. This, in turn, can have a profound impact on mental health and overall well-being, further exacerbating the stress associated with fertility issues. Therefore, mental well-being plays a pivotal role in an individual's emotional and interpersonal health.
How can we address this challenge?
Fertility challenges faced by men receive less attention and remain a hushed topic in most cases. It is important to flush out the cultural stigmas and taboos surrounding male fertility issues. These societal biases obstruct open conversations and discourage men from seeking necessary medical assistance. Encouraging men to voice their concerns is a challenging but vital endeavour because avoiding important discussions can lead to severe consequences, including marital discord and mental health issues. Most individuals can benefit from the support of their family, friends, healthcare providers, and mental health professionals. It is essential to normalise the act of seeking professional help when needed. Practices like meditation, yoga, engagement in hobbies, and consulting experts can aid individuals in maintaining a healthy equilibrium in their personal lives and ensuring optimal mental well-being. Increased awareness campaigns and changing societal attitudes are the need of the hour to foster a healthy and supportive environment for men battling infertility.
What role does a counsellor play for couples battling infertility or undergoing fertility treatments?
Establishing a strong rapport and assisting individuals in identifying the root causes of their concerns are essential steps in providing support. Counsellors help people develop deeper connections, engage in introspection, and holistically evaluate their issues to achieve peace of mind. With the help of a variety of stressors, counselors assist individuals in managing their chronic stressors. Coping mechanisms play a crucial role in addressing different emotional responses to stress and in developing personalised preventive interventions. Throughout the journey, counselors guide individuals to express their fears, worries, and anxieties through various therapeutic techniques, such as focus group discussions and individual assessment sessions.
What is your advice for couples battling this issue?
Following are a few tips for couples navigating the emotional challenges of infertility and trying to conceive:
Emotionally connect: Make time to regularly check in with each other emotionally. Find ways to keep the spark alive in your relationship and remember that your journey to parenthood is a shared one with your partner.
Physical health: Physical health is crucial during one’s fertility journey and hence, adopting a healthy lifestyle characterised by the intake of a well-balanced, nutritious diet; healthy sleep and exercise routine, avoiding substance abuse and employing practices such as wearing breathable pants, digital well-being (staying away from digital electronics) remains paramount.
Seek counselling: Consider seeking the assistance of a counselor if you are feeling stuck and need help overcoming persistent feelings of dullness, stress, loneliness, grief, guilt, depression, anxiety, or other mental health challenges.
Focus on the present: Avoid dwelling on the past (‘should haves’ and ‘could haves’) or worrying excessively about the future; rather concentrate on the present.
Practice self-care: Treat yourself with the same care you give to your family and friends. Ensure you get enough sleep, engage in regular exercise, spend time alone, and maintain social connections to make yourself feel cared for. Be your own best friend and prioritise self-care.
Positive self-talk: Offer yourself positive self-talk and encouragement. What you say to yourself has a significant impact on your mood. Remind yourself that there's always a way forward, and this positive outlook can help lift your spirits.
Join support groups: Consider joining support groups where you can connect with others facing similar challenges. These groups can provide a sense of community, boost self-esteem, and offer valuable guidance.
Cognitive restructuring: Practice cognitive restructuring by examining your thought patterns and perspectives. Explore different viewpoints to create new behaviours and emotions. This process can help you develop a more adaptive mindset when dealing with infertility-related stress.
