Infertility stigma: Men rarely face the brunt for wife’s delayed pregnancy

D4C Reporter

Married women in India get blamed unfairly for all problems related to delayed or lack of pregnancy, especially in semi-urban and rural areas, forcing them to singularly bear the stigma of infertility while their husbands rarely face stinging questions for the couple’s inability to expand their family, say experts.

However, in about 25-35% cases of couples facing reproduction challenges it is the male partner whose medical condition, like low sperm count or diabetes, is responsible for the fertility complications.

According to medical experts and researchers who have studied impact of infertility related stigma, women end up with complications like mental health issues and poor quality of life due to the stigma which in most cases is due to curable medical condition – both their own and their partner’s.

WHO data shows that the estimated prevalence of primary infertility among reproductive age group women in India is 11.8%. The positive aspect of this data is that it leads to the conclusion that 9 out of 10 women are fertile and capable of bearing a child.

Doctors blame a lack of awareness and social conservativeness for women being “branded” as infertile even when the reason for her not bearing a child lies in her husband’s medical condition.

Gurugram-based IVF specialist Dr Puneet Arora from Centre for Infertility and Assisted Reproduction (CIFAR) confirmed a social bias against women in cases of delayed pregnancy or complications.

“I have come across a case where a woman had been undergoing treatment for six months for optimising reproductive health through medicines but eventually it turned out that her husband had a very low sperm count,” said Dr Arora.

“Since the family was facing delays in pregnancy, the woman’s family made her visit a fertility clinic while her husband did not bother to undergo any check-up for six months,” she said.

Dr Arora, who heads CIFAR, said that in a patriarchal society like ours there is a greater tendency to blame the woman and not her husband for any issues related to delayed pregnancy.

“This is the reason, why we at CIFAR strictly follow the protocol of calling couples for consultations – which is always better than two individual sittings for a man and her wife,” she said.

In India, the world’s most populous nation, infertility is most often than not blamed on women, impacting their self-esteem. The situation gets complicated further due to a couple’s lack of awareness, financial constraints and societal pressures.

A study “The impact of stigma on mental health and quality of life of infertile women: A systematic review” by researchers at School of Nursing and Public Health, Yangzhou University, Yangzhou, China, tried to analyse the impact of stigma of infertility on women.

“The stigma of not giving birth to children affects approximately 53. 08~64% of female infertility patients worldwide. This stigma not only causes harm to the mental health of these infertility patients, but also affects their quality of life, making them bear the adverse social consequences such as domestic violence, marriage breakdown, or even delay in receiving the treatment. Therefore, it is crucial to have a deep understanding of the patients’ stigma and effective intervention in alleviating it,” the study said.

Experts suggest that there are a number of factors responsible for fertility issues faced by couples in India. In many studies conducted in this field it was found that lifestyle diseases like diabetes and obesity also have a huge bearing on fertilisation. Other factors include fibroids, polycystic ovarian syndrome and sexually transmitted infections. Environmental factors such as exposure to fertilizers and pesticides, especially in rural area, also impact fertility.

Dr Arora pointed to lack of information and data on prevalence of primary infertility in India for effective policy level interventions. She said the issue is not only under-researched but also has health and socio-economic implications which need urgent attention.

According to Dr Arora, sensitisation of both genders on issues related to childbearing could go a long way in dispelling myths.

“Our experience at CIFAR has been that almost 8 out of 10 infertility cases can be managed with simple, routine treatments. Only genuine cases need to be referred for advanced infertility treatments like IVF, egg donation, or surrogacy,” she said.