Baranwal Anshu, Chattopadhyay Aparajita
International Institute for Population Sciences, Mumbai, India.
Front Sociol. 2020 Jul 28;5:43. doi: 10.3389/fsoc.2020.00043. eCollection 2020.
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.
本文旨在了解男性因素不育症患者的求医行为及经历。鉴于在不孕症治疗中男性未被视为与女性同等重要的部分，在印度孟买经同意的医院/不孕症治疗中心开展了一项横断面研究。这里将不育男性定义为被诊断患有原发性或继发性不育症、正在接受不孕症治疗的男性，无论其妻子的生育状况如何。通过半结构化访谈收集了150名来自不同社会经济背景、正在接受不孕症治疗的男性的原始数据。不育状况的最初影响使这些男性感到沮丧、内疚、震惊和孤立。很大一部分受访者除了与妻子外从未与任何人讨论过这个问题。超过三分之一的受访者咨询过阿育吠陀、尤那尼、悉达和顺势疗法（AYUSH）从业者。更换医生或诊所更多是归因于治疗周期未成功以及其他诊所的成功率，而非医生的推荐。命运、运气不好、生活方式、医学原因和晚婚被认为是男性不育的原因。40岁以上、结婚年龄较小、结婚年限6年及以上、继发性不育、自营职业和较高收入与结婚和开始不孕症治疗之间的较长时间间隔有显著关联。基于研究结果，我们提出信念与实践理论，阐述男性不育症治疗的进展。在不孕症治疗中应给予男性应有的考虑。由于男性不育的小问题通过适度用药即可治愈，因此在生育力评估的早期阶段就必须考虑到男性。适当的信息教育与沟通（IEC）对于提高社会对男性不育症的认识至关重要。治疗期间更好的咨询服务和费用标准化可以帮助不育男性应对与治疗相关的压力。由于不孕症治疗是一个耗时且令人疲惫的过程，考虑患者创收工作的时间、设立夜间门诊部以及在健康中心进行全面的知识传播可以改善男性因素不孕症的治疗。
