Male infertility affects about 1 in 6 to 10 men worldwide, making it more common than diabetes. Yet, while diabetes is openly discussed, screened for, and the subject of educational campaigns, male infertility remains largely under the radar. People are well-informed about diabetes, its causes, and risk factors—but do men have the same level of awareness about their fertility?
Despite the fact that male infertility is so widespread, there’s a significant lack of awareness, education, and support for men facing what is often one of the most challenging periods of their lives.
For the most part, the education system does little to inform either men or women about fertility and possible fertility problems. School pupils are taught about the menstrual cycle and contraception but nothing about spermatogenesis. As a result, many men are unaware of how common fertility issues are and often don’t consider that their fertility might be the issue when struggling to conceive.
Why is this important? Simply put, knowledge is power. For men facing difficulties starting a family go for a fertility assessment, they often have no idea that they might be part of the problem. Society tends to assume that fertility problems stem from the woman, so when men receive the news that they have an issue, it can come as a total shock.
What makes things worse is that fertility results are often communicated in a casual, impersonal manner, as though checking sperm quality were as routine as a blood pressure check. Many men receive their results by email, text, or even from a receptionist, with little to no explanation. Often, they are left confused, wondering what the results mean. If the results are suboptimal, they may be referred to a fertility clinic, but the focus tends to shift toward the woman, leaving men with minimal guidance or support. Also, fertility clinics are gynaecology-driven, and the man is then “seen” by a “fertility specialist” who is a gynaecologist (specialised in female fertility issues). Men should see a male fertility specialist, an andrologist.
By the time a man takes a semen analysis test, the couple has often been trying to conceive for months, if not years, creating a lot of pressure around sex, which can become a mechanical, stress-filled activity centred around the woman’s ovulation cycle. This pressure can lead to performance issues, only adding to the emotional strain. So, when a man is told his sperm is not “good enough,” it can be a devastating blow.
There seems to be a strange link between sperm quality and a man’s ego. Reproduction is a primal instinct, and men rarely question their ability to father a child. Being told they have poor sperm—or none at all—can feel like an assault on their very identity.
For many men, a diagnosis of infertility triggers intense emotions, ranging from denial to depression, alcohol abuse, and even suicidal thoughts. The founders of testhim, Toby Trice, Michael Close and Ian Stones, have run male fertility support groups for years, and the stories they hear are often heartbreaking. Men describe feeling lost, unsure of how to support their partner, or where to turn for help. Some have even given their partners “permission” to leave them because they feel incapable of giving them the child they want. Some other men are also put under tremendous pressure by their partners which can in turn cause or add to depression.
This emotional toll isn’t just anecdotal, research confirms the deep impact male infertility has on mental health. Studies show that men with fertility issues experience lower self-esteem and tend to rely on fewer coping mechanisms, turning to work or hobbies as distractions. In one study, 28% of men felt that their sperm quality affected their sense of masculinity.
Despite these struggles, men are less likely to seek psychological support like counselling or therapy and are more reluctant to open up about their infertility. Many avoid discussing it with anyone other than their spouse, with studies showing that nearly half (47%) of men don’t talk to anyone else about their fertility problems. Performance anxiety and sexual dysfunction are also common, adding to the emotional strain.
Unfortunately, the stress of infertility can further harm a man’s fertility. Some studies suggest that high stress levels can affect hormone production and sperm quality, creating a vicious cycle.
So, how can we address this issue? Infertility is complex, affecting both men and women emotionally, but often in different ways. For over a decade, research has pointed to the need for better support services and engagement with male patients, but stories from those affected show that progress has been slow.
Men facing infertility are at greater risk of isolation and mental health struggles, exacerbated by societal norms and a healthcare system that centres around women. We need broader conversations—among medical professionals, in schools, and across society—about the impact of infertility on men. It’s crucial to create spaces and resources where men can talk openly without fear of judgment or ridicule.
Though there’s still much work to be done, progress is being made and the work testhim are doing in this area is making a big difference. In the meantime, men must take responsibility for both their fertility and mental health. While support may not always be readily available, resources do exist. Finding them may require effort, but the path to support should be made easier, with more accessible spaces for men to reach out and seek help.
If you’re a man struggling with infertility you can access a variety of support services through testhim who are dedicated to providing education, awareness and support for men dealing with infertility.