Identity suffering in infertile men

Abstract

The suffering caused by infertility in a man can have multiple aspects. It can display a narcissistic dimension, an objectal dimension (object-libido) turned toward others or/and an identity dimension. Two clinical case reports were used here to (i) illustrate all these aspects of infertility suffering, (ii) to evidence the difficulty for infertile men to speak about their infertility and (iii) underlie the importance for professional of medical assisted reproduction to be attentive to this suffering that many men keep silent. An empathetic attention to infertile men may give a way to express this suffering and thus allow the beginning of a psychoanalytic approach which is necessary in infertility and especially for infertile men who do not easily express their suffering.

Redox regulation of mammalian sperm capacitation

“…The capability of scavenging different ROS makes PRDXs valuable candidates in the protection of spermatozoa against oxidative stress. The six members of the PRDX family are differentially localized in subcellular compartments of human spermatozoa, 86 87 circumstances that allow local control of ROS levels. Within the PRDX family, PRDX6 is the most abundant isoform in human spermatozoa.…”

“… 100 Moreover, its inhibition by sodium azide did not reduce H 2 O 2 scavenging capacity nor increased lipid peroxidation in human spermatozoa treated with 1 mM H 2 O 2 . 87 GPX2, 3 and 5 are not present in the human testis, seminal plasma or spermatozoa 101 102 and GPX4 is inactive as an antioxidant enzyme but is important in the formation of the mitochondrial sheath. 103 104 105 The possible role of GPX1 in spermatozoa is controversial because GPX1 activity was measured using cumene hydroperoxide and NADPH, 106 substrates also used by PRDXs.…”

“…The PRDX family members are attractive candidates in regulating the levels of ROS for physiological functions because of their abundance and strategic localizations. 86 87 Human spermatozoa incubated under capacitating conditions with fetal cord serum ultrafiltrate in the presence of thiostrepton, an inhibitor of 2-Cys PRDXs, 107 showed reduced levels of tyrosine phosphorylation in a dose-dependent manner compared with controls in the absence of the inhibitor ( Figure 5 ). These results indicate the need for active 2-Cys PRDXs to assure tyrosine phosphorylation during capacitation, possibly by regulating ROS action.…”

To be or not to be [fertile], that is the question

“…On the other hand, it was already shown that men may feel guilty about what their partner has to go through during ART (ovarian stimulation, oocyte retrieval, etc.) [ 9 , 23 ]. Our results suggest that men diagnosed with infertility may feel disappointed, ashamed and guilty with regard to their partner - even before the initiation of an ART treatment programme.…”

“…It was shown that the announcement of male infertility can cause the same reactions as that of serious illness: shame [ 4 – 6 ], guilt, depression [ 1 , 5 – 8 ], anxiety, stress [ 1 , 7 ], decreased self-esteem and a desperate search for a cause. Furthermore, infertility may call a man’s sexual identity into question [ 9 , 10 ]. A diagnosis of infertility may make a man feel unsatisfied with his life [ 11 – 13 ] and may even prompt suicidal feelings and strain in his marital, social and/or sexual relationships [ 7 , 11 , 12 , 14 – 16 ] because of the close relationships between fertility and sexuality [ 15 , 17 – 19 ].…”