Couples Therapy can Help Couples Faced with Male Factor Infertility

You finally found someone you want to spend your life with. You’re ready to start a family and then bam! You go to the doctor and learn it’s not going to be that easy–and on top of that, it’s “his fault.” Male factor infertility has thrown a one-two punch right where it hurts.

While he’s doubled over from the hit, your relationship is also suffering. He might feel like you’re angry with him for not performing, or he doesn’t know how to talk to you about what the loss means to him.

Fatherhood. Masculinity. How does he see himself now? What does it mean for your relationship and for your future?

Couples therapy can help you explore all these questions together, make you more resilient, and strengthen your connection in the face of this life-changing reality.  

Male Factor Infertility

Male factor infertility is common. It accounts for half of all infertility that heterosexual couples face.

Yet, most discussions of infertility focus on women (Fisher & Hammarberg, 2010), and the burden of infertility is mostly placed on women in mix gender couples. This makes the experience even more difficult for men because social norms and supports are geared towards dealing with female infertility.

Myths Around Male Infertility

Researchers have identified the following myths around male infertility (Fisher & Hammarberg, 2010):

1. Fertility equals virility and masculinity. In many cultures, ours included, male infertility is considered a “crisis of masculinity.” There’s some idea that if you’re infertile, you’re not a “real man.” Infertile men may be seen as weaker than their peers, or the condition may be conflated with their ability to perform in other environments such as the workplace.

2. Men don’t want to have children as much as women do. There is some idea that fatherhood is not central to a man’s identity as motherhood is for women. The effect of this myth is the resulting idea that infertility is less distressing for men.

Social assumptions like these are inaccurate and are slowly changing. Contrary to these assumptions, research shows that fatherhood is as important to men as motherhood is to women, and that the loss of fatherhood is as distressing to men as it is to women.

But the stereotypes around male factor infertility touch at the core of who men are. It becomes shameful not to be able to have a child. Additionally, it undermines how men feel about themselves and causes added distress. 

No wonder men feel their masculinity is threatened when they learn they’re infertile.

And it’s not surprising if they don’t feel safe to open up and talk about it for the fear of being judged and devalued.

How Men Feel When Dealing with Male Factor Infertility

With the myths out of the way, the following represent what researchers have learned in the last ten to fifteen years about what men might actually experience when dealing with infertility (Fisher et al., 2010; Joja et al., 2015):

  • Low self-esteem: Failing in his social role, not feeling adequate as a man
  • Resentment: Other men are having children
  • Guilt: Depriving his wife of children
  • Isolation: Too difficult to talk about the infertility
  • Shame: Feeling broken, like something’s wrong with him
  • Secrecy: Afraid of revealing the infertility and being judged and stigmatized

Altogether, the disenfranchised grief, shame and stigma he’s experiencing influence the relationship between the two of you. Not only might he be feeling some of that guilt, resentment, and low self-esteem, but he’s likely feeling somewhat isolated from you, his partner. Or your relationship might be stuck in cycles of conflict.

Pile-up of Infertility Stress

When going through infertility treatment, both you and your partner are probably stressed.

The cost in both money and time that infertility treatment requires can have significant strain on the relationship. On top of that, both of you become consumed with getting pregnant and it takes over all aspects of your life (Brigance et al., 2020).

Now leisure time and physical intimacy are gone.

Emotional strain leads to anxiety, low self-esteem, guilt, and eventually to relationship problems. Then these relationship problems add to the stress you’re already facing as a couple.

Infertility, whether male factor infertility or otherwise, leaves both of you with intense emotions that can easily turn into mutual blaming, shaming and anger (Brigance et al., 2020). From there, your communication suffers.

You can’t talk to each other without raising your voice about simple things, and your relationship feels damaged. How are you going to make complex medical decisions as a couple?

How Couples Get Stuck

In general, though not as a rule, our society has raised men who are not so good at talking about their feelings.

He’d rather distract himself and focus on something else. He doesn’t want to talk about how much it hurts.

To you, this might look like your partner has shut down. He’s not letting you into his inner world, and you feel alone.

In your isolation, you become increasingly anxious. You want to talk because this is your way of coping and processing your anxiety. Additionally, you worry that if you don’t bring up the topic of having a child, he will never talk about it. But the more you want to talk about your ideas about treatment, the more he wants to retreat, and the more you pressure him to talk.

And on and on it goes.

Your partner is likely triggered by your ideas of what you can do for his infertility (e.g., diet, supplements, acupuncture). Deep down he’s in pain, feeling guilty and inadequate, and telling himself “I’ve let her down.” “I’m not good enough for her. She should go and find another man who can give her children.”  

He copes with these feelings by tuning out, shutting down, denying them, or getting defensive.

He doesn’t feel safe to open up, so he hides and avoids you even more. Both of you end up alone and hurt. You’re stuck in a negative interaction pattern.

You don’t know how to turn to each other and help heal the other’s hurts.

Couples Coping Together through Male Factor Infertility

Your partner is your biggest source of strength and hope through infertility challenges. And the best and most effective way to cope with infertility and pregnancy loss is your strong relationship.

Researchers have studied the effect of a supportive partner on our experience of fear and pain. In one experiment, James A. Coan used an MRI machine to observe women’s reactions to the threat of an electric shock while holding their husbands’ hands versus when they laid in the machine alone. When holding their husbands’ hands, the women reported feeling less fear at the threat of the shock and less pain when actually shocked than when they were alone or holding the hand of a stranger (Coan et al., 2006).

The presence of your supportive partner soothes not only your nervous brain but also physical sensations of pain.

Being physically and emotionally present for your partner allows you both to meet difficulties head on, knowing that it will be less painful as long as you’re doing it together.

Benefits from Couples Therapy for Couples Going Through Infertility

Couples therapy, particularly Emotionally Focused Therapy (EFT), improves connection between partners and create lasting satisfaction in the relationship (Johnson, 2017). It’s been proven by research to be effective in reducing stress and improving communication for couples going through infertility (Najafi et al., 2015; Soltani et al., 2014).

Couples therapy will help you process your own feelings, be empathetic to each other, and use each other for emotional support (Brigance et al., 2020).

Together, you’ll create a safer and more trusting relationship and a renewed sense of being partners in this life challenge. Couples that have successfully navigated infertility see this as “our problem,” and work together in surmounting it.

Finally, couples therapy can result in not only emotional intimacy, but also renewed or improved physical intimacy—and hope and confidence in building a family together, whatever it takes.

About Dr. Irena

Dr. Irena has extensive experience, over 20 years, of helping couples and individuals deal with male factor infertility and the strain it puts on the relationship.  As a certified EFT couples therapist, she has helped numerous couples successfully navigate challenges of infertility as a team.

Dr.Irena offers online therapy in Houston, The Woodlands, and New York. Email Dr. Irena for a free 10-minute video consultation: or call (281)-267-1742.


Infertility: An Emotionally Focused Couples Therapy Approach. The Family Journal: Counseling and Therapy for Couples and Families.

Coan, J. A., Schaefer, H. S., & Davidson, R. J. (2006). Lending a hand: social regulation of the neural response to threat. Psychological Science, 17(12), 1032-1039.

Fisher, J., & Hammarberg, K. (2010). Psychological and social aspects of infertility in men: an overview of the evidence and implications for psychologically informed clinical care and future research. Asian journal of andrology, 14(1), 121-129.

Fisher, J. R., Baker, G. H., & Hammarberg, K. (2010). Long-term health, well-being, life satisfaction, and attitudes toward parenthood in men diagnosed as infertile: challenges to gender stereotypes and implications for practice. Fertility and sterility, 94(2), 574-580.

Johnson, S. (2017). Deciphering the Language of Love. Scientific American Mind, 28(4), 35-43.

Joja, O. D., Dinu, D., & Paun, D. (2015). Psychological Aspects of Male Infertility. An Overview. Procedia – Social and Behavioral Sciences, 187, 359-363.

Najafi, M., Soleimani, A. A., Ahmadi, K., Javidi, N., & Kamkar, E. H. (2015). The Effectiveness of Emotionally Focused Therapy on Enhancing Marital Adjustment and Quality of Life among Infertile Couples with Marital Conflicts. International Journal of Fertility and Sterility, 9(2), 238-246.

Soltani, M., Shairi, M. R., Roshan, R., & Rahimi, C. R. (2014). The impact of emotionally focused therapy on emotional distress in infertile couples. International Journal of Fertility and Sterility, 7(4), 337-344.

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