Infertility Has a Male Problem
When infertility is in play, why do we continue to focus on her and overlook him?
Posted May 28, 2026 | Reviewed by Margaret Foley
E and J sat in front of me. She had her arms crossed. He sat slightly apart, turning his phone over in his hands. They were nice people. Smart, thoughtful, both with careers they liked.
So why were they in my office?
Something intangible.
For many months, the two of them had moved through fertility investigations and treatment. Hormone panels. A miscarriage . Two egg retrievals. All of it focused on E.
Until J’s brother, going through his own fertility journey, discovered a genetic issue with his sperm. J brought it to the doctors immediately. And only then did the attention turn to him.
What E had been carrying, for the longest time, wasn’t actually hers to carry. She had shouldered the blame, even though J hadn’t openly blamed her. In fact, J had been transparent the moment he knew.
Neither of them knew how to talk about it, or why E had resentment and J had confusio n*.
Much has changed in terms of fertility treatment. Research has expanded, treatments have improved, and public conversation has opened up in ways it never used to.
But something remains essentially stuck.
Infertility is still widely treated as a woman’s issue. You see it in who walks into the clinic first, who gets tested first, and in who initially carries the weight of something “being wrong.” It is often an automatic assumption, fueled by the commonplace idea of the biological clock that’s racing against time. So, naturally, she approaches the doctor first.
His Clock Was Always There Too
It’s interesting to me that male sperm aging is still treated as an afterthought, though the data has been there for a while.
Sperm quality begins to decline in the mid-30s and accelerates after 40 (Harris et al., 2011; Xie et al., 2025). Volume drops, motility slows, and DNA fragmentation rises. Advanced paternal age has also been linked to longer time to conception, higher miscarriage risk, and elevated risk of certain neurodevelopmental conditions in offspring, including autism and schizophrenia (Sandin et al., 2016). At least 6,800 sperm samples later (Xie et al., 2025), we know his clock has always been there.
It’s not surprising then that half of all infertile couples have a male-factor component. More specifically, male factors are the sole cause of infertility in 20 to 30 percent of cases and contribute to another 20 to 30 percent (ASRM, 2025).
Infertility is therefore not a one-person problem. It is, statistically and biologically, a shared one. Yet somehow this gets lost in translation. The medical system follows her around like a shadow she can’t shake.
This deep-rooted pattern was not an oopsie-daisy, a we-didn’t-have-the-vocabulary-back-then kind of accident. It has a long history. For centuries, patriarchal social structures consistently located reproductive “failure” in women (Inhorn, 1996). Virility, fatherhood, and lineage were tied to a man’s social standing. Questioning his fertility would challenge that system.
So, the burden of blame shifted sideways (Vignozzi et al., 2025), and medicine followed; diagnostic pathways have been built around this so-called specialness of hers. Cultural scripts followed only the female, with the most invasive testing and procedures, way before a basic semen analysis became a topic. The whole edifice was, to borrow from Alice in Wonderland, “nothing but a pack of cards.”
The evidence has moved on; the practice and narrative still have a long way to catch up.
When Responsibility Lands on One Body
Thirty to 60 percent of women experiencing infertility face significant mental health challenges, with higher rates of anxiety and depression than their male partners (Society for Women’s Health Research, 2024). It's no surprise, then, that she bears disproportionate stigma , stress , and relationship pressure; this pattern has been documented globally (WHO, 2023).
But stats aside, when the system assumes the problem is hers, she begins to internalize it too, even when there is no habeas corpus — no charge, no evidence, no case.
She apologizes to her partner, feeling embarrassed that she has introduced something into the relationship. She scans her body for fault, quietly self-flagellating for waiting too long, or for pursuing the higher echelons of a career that has traditionally belonged to men. This is what cultural assumption does. It moves quietly into the crevices of our interior life.
And this is what we see with E and J.
This is a script that had been handed down long before either of them stepped into my office. She knew her lines, and he knew his. She had absorbed the blame as if it were always hers, and he had duly stepped aside. Neither of them saw any of the backdrop, which caused the confusion and smoke and mirrors to the point that they had no words to talk about it.
What is less often named is what this imbalance does to men.
When infertility is framed as her problem, men are positioned as observers. They become the supporter, the driver, the hand holder, the problem solver. Not because they care less (though yet again our culture does a number on them, where expressing emotion gets misconstrued as weakness), but because the system has restricted their role.
When the cause later turns out to be a male factor, that quiet position becomes disorienting. Male infertility is consistently associated with depression, anxiety, lowered self-esteem , and disruptions to masculine identity (Sahoo et al., 2025). Many men also report emotional suppression, isolation, and a reluctance to seek support, partly because fertility services rarely include them in any meaningful way (Miner et al., 2019).
So, what are we left with here? A patriarchal system that doesn’t actually protect men. It isolates them. It tells them they should not be the patient. And when they finally are, it offers them very little. Ironic, really.
Two people. Two different ways of being unseen.
Toward Something More Accurate
If the evidence has been clear for decades, why hasn’t practice fully caught up?
Narratives about identity are deeply embedded and slow to shift. Systems repeat themselves long after science has evolved.
Psychologically, when something is uncertain, people look for somewhere to locate the problem. The more visible body usually becomes the one to latch onto. But the simplification creates distortion.
A more balanced approach is also a more accurate one. Evaluation should begin with both partners. Early and without assumptions. Care should reflect the shared nature of infertility, not reinforce outdated narratives. This changes the emotional experience for everyone in the room. When responsibility is shared, conversations open up and the relationship has more room to breathe.
If we apply this to the bigger picture, one of the deepest struggles many couples face is that powerful hidden forces operate beneath the surface. The reframe is not simply to "fix" the conflict as quickly as possible, but to become curious about the emotional architecture shaping the relationship, rather than remaining unconsciously governed by it.
While painful, this process can become an opportunity to understand each other more deeply, and to ensure that this part of life isn’t a mystery operating silently in the background.
- Names and identifying details have been changed to protect privacy.
American Society for Reproductive Medicine. (2025, April 21). Half of infertility cases involve men. Why does care still treat it as a women’s issue? https://www.asrm.org/news-and-events/asrm-news/press-releasesbulletins/…
This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.