Advice from Men Who Have Overcome a Male Infertility Diagnosis

Men as a species are pretty good at adapting to the new or different, to judging and taking risks and to responding to the unknown. I didn’t say perfect, but pretty good. Indeed, this ability has allowed them to surf waves the size of mountains, run the mile in well under 4 minutes, run companies, raise families, make money, and just simply survive in an ever-changing world. But, tell a man that he is infertile, and he may resemble a deer in headlights. Being infertile strikes at a man’s very core and is an unknowably devastating blow to id, ego and superego.

A Freudian View

I have often wondered why an infertility diagnosis is so disabling for men. I’ve published that being infertile affects men’s sex lives, self-esteem and social interactions. And now I look to Freud for a deeper explanation of this response. The Freudian view of humans is that of id, ego and superego. Id represents the entirely unconscious man, and includes the instinctive, infantile and primitive behaviors that are driven by satisfying “pleasures” such as eating, sleeping and reproducing. Ego is derived from both the conscious and unconscious mind, and it ensures that the id is expressed in a socially acceptable manner. Freud compared the id to a horse and the ego to the horse’s rider. The horse provides the power and motion, and the rider governs and directs. Overseeing all of this, the superego bears the moral standards and ideals learned from parents and society. It provides the right and wrong guidelines for making judgments and tries to perfect and civilize behavior.

A Freudian Fault

When it comes to reproduction, the id sees it as an instinctive need, as basic as hunger. It is essential and fundamental to life. Neither the ego nor the superego questions this priority, as it is so basic in nature. As an unchallenged cornerstone of being human, reproduction fails to capture the attention of the ego and super ego…until there is a problem. And when infertility surfaces, there is no real foundation for a coherent response. Hence, emotional chaos results. In the words of Freud, “Men are strong so long as they represent a strong idea.”

A Freudian Response

Over the last quarter century, I have seen every response imaginable when men are informed that they are infertile. Infertility affects self-esteem and self-identity like few other mortal challenges. You were put on this good earth to reproduce, and yet you can’t? This goes deep. And, since feelings about fertility and sexual adequacy are often intertwined, infertility can lead men to question their masculinity and sexual prowess. The id, ego and superego are entirely unprepared for this.

I have also seen the tremendous inner strength that men reveal when faced with infertility. This tends to occur with the following realizations:

• That some things are out of your control
• That some things are actually in your control
• That knowledge and facts are power and can help you navigate the unknown
• That overall health matters
• That emotional support matters

Freud actually nailed it when he said: “Being entirely honest with oneself is a good exercise.” So true when it comes to dealing with the unexpected in life. And, reflecting on the personal growth that is possible in adversity, he also said: “One day, in retrospect, the years of struggle will strike you as the most beautiful.”