Proposition of Belief and Practice Theory for Men Undergoing Infertility Treatment: A Hospital Based Study in Mumbai, India

Abstract

The paper aims to understand the treatment seeking behavior and the experiences of men with male factor infertility. A cross-sectional study was conducted at consented hospitals/infertility centers in Mumbai, India in purview of the fact that men are not considered as important as a part of infertility treatment as women. An infertile man is defined here as one who is diagnosed with primary or secondary infertility, undergoing infertility treatment, irrespective of the fertility status of his wife. Primary data of 150 men undergoing infertility treatment from a variety of socioeconomic backgrounds was collected through semi-structured interviews. The initial effect of the infertility status led the men to feel depressed, guilty, shocked, and isolated. A large proportion of the respondents never discussed the problem with anyone except their wives. More than one third of the respondents consulted with Ayurvedic, Unani, Siddha, and Homeopathy (AYUSH) practitioners. Changes of doctors or clinics were more attributed to unsuccessful treatment cycles and success rate of other clinics than the referral by doctors. Destiny, bad luck, lifestyle, medical reasons, and late marriage are found as perceived causes of male infertility. Age above 40, younger age at marriage, marriage duration for 6 and more years, secondary infertility, self-employment, and higher income have significant association with longer time gap between marriage and initiation of infertility treatment. Based on study findings, we propose Belief and Practice theory where we elaborate the progression in treatment for male infertility. Men should be given due consideration in infertility treatment. They must be taken into consideration at an early stage of fertility evaluation due to the fact that minor problems of male infertility can be cured with modest medication. Proper Information Education and Communication (IEC) is essential for creating awareness in society on male infertility. Better counseling services during treatment and standardization of cost can help infertile men to manage treatment-related stress. Since infertility treatment is a time-consuming and exhaustive process, considering the timing for patient's income generating work, evening out patient department, and comprehensive knowledge dissemination at health centers can be improve male factor infertility treatment.

Feasibility analysis of incorporating infertility into medical insurance in China

“…Through the examination of male infertility, we can achieve timely prediction and prevention of cardiovascular diseases, occurrence or development chronic comorbidities, and mortality and improve the overall male health survival. We can gradually and comprehensively raise people’s awareness of male infertility and improve men’s awareness of going to a hospital for examination through many ways—classroom education in schools, popularization in the process of routine physical examination and medical treatment in hospitals, and publicity in communities ( 7 ).…”

“…It is estimated that male factors cause about 50% of infertility, but male factors rarely cause attention to couples’ infertility ( 7 ). Male factors must be fully considered in infertility treatment.…”

“…Moreover, 15% of adult men have clinical varicocele, 35% present infertility, and up to 81% may have secondary infertility ( 12 ). The infertile male should undergo timely semen analysis, physical examination, hormonal evaluation, gene testing, and imaging as well as organic surgery ( 7 ). Correcting sperm defects should be included in the management practices of infertile couples, such as severe oligospermia leading to a low success rate of intracytoplasmic mirror injection ( 13 ).…”

“…The top reason for not seeking treatment in hospitals was financial status, which accounted for 23% ( 39 ). An investigation showed that standardization of examination and treatment costs can encourage infertile men to deal with stress ( 7 ). The survey by Wang et al identified that 92.4% of patients continued their treatment with 39.7% success of pregnancy, and 55.1% patients visited two or three hospitals with 47.1% success of pregnancy.…”

The Association Between Infertility and Highly Educated Working Women and its Residence-Wise Prevalence: Insights from India

“…The standard of living is another signi cant factor in uencing infertility, and its prevalence increases with an increase in the standard of living. Although the treatment of infertility is easily accessible and affordable for the wealthiest women as compared to the poor [19,30], the condition of infertility is also seen mostly in them because of the decent standard of living, women go to higher education, and want to become nancially independent by doing the job, which also delays marriage. The standard of living is a highly signi cant indicator of infertility in the urban area, while the impact of this indicator is not very high in rural areas.…”