Impact of subfertility

Impact of subfertility

Irrespective of the society, culture, class, division, and educational status of an individual, subfertility effects both the male and the female. Both have an equal sense of the debarment; nevertheless, it has been observed that for various reasons in different cultures, females are stigmatized for being responsible for this condition. Influence of infertility has resulted in the aggravation of medial, social, psychological, and economic burdens of developing countries. Infertile couples receive discriminative treatment from society, especially from friends and relatives. Our culture imposes social pressure more on newly married women in this context, especially to have sons. The debarment places infertile women in a lonely place shadowed by pain, agony, sorrow, and empathy. Various losses faced by infertile couples may include loss of health, self-esteem, self-assurance, parental identity, personal control, genetic legacy, grand-parenting relationship, trust in religion, optimism in the future, sexual identity, and childbearing and child-rearing experience in the long list of deprivations for the infertile couples. Commonly, infertile females of the Third World countries feel profound self-reproach and embarrassment for this condition. Generally, the impact of infertility can broadly be characterized into physical, social, psychological, and economic factors.

Effect on the marital relationship

A number of infertile females regret to accept that during their struggle with subfertility, their relationship with their husbands has been negatively affected. Stress-related alteration of the hypothalamic–pituitary–adrenal (HPA) axis influences the human pituitary ovarian (HPO) axis, which results in the modified sexual behavior along with changes in the luteinizing hormone-releasing hormone and luteinizing hormone levels. Increased levels of cortisol and proopiomelanocortin (POMC) reduce the synthesis of sex hormones accounting for the changes in the HPA and HPO axis, which along with other hormones affects the release of oxytocin. Oxytocin is also involved in the maintenance of social and sexual life. Evidence shows that adequate levels of oxytocin keep the mood and sexual drive of a female elevated; however, it modulates the transport of the sperm within the female genital tract.

Many a times the psychological irritability going on within the woman’s mind, the burden of treatment, its schedule, and the finances involved in this process make the marriage stressful. It has been observed that some men are against the infertility investigation and treatments as; (i) they are petrified of being responsible for the cause (male infertility), a big taboo on manhood!, (ii) it comes with financial burden (especially for the rural dwellers), (iii) they do not want to miss the chance of second marriage, (iv) they are unaware of the treatment success rate and its impact, (v) they are too busy to actually feel the debarment, and (vi) the believe it collides with their social and religious beliefs. In some scenarios, the man demands child but females are either: (i) not willing for the treatment and (ii) too career-oriented and feel that an additional responsibility of becoming pregnant and bearing a child might hinder their success. Whatever the reason, subfertility leads to arguments and eventually affects the marital relationship.