The Next Big Conversation in Fertility Medicine
The field is finally waking up to the fact that men need their own support during the conception journey.
Last year, when Daniel Miranian and his wife attended their nine-week pregnancy ultrasound, his education as a fertility doctor came full circle. As the couple stared at the screen and saw that the fetus had no heartbeat, he felt the gut punch of miscarriage firsthand.
Today, he believes that experience made him a better fertility doctor. “You grieve the loss of what you had hoped for that child,” says Miranian, a reproductive endocrinologist at Reproductive Medicine Associates in Philadelphia. “It's certainly made me a lot more empathetic to just how hard that can be to overcome.”
When Miranian learns that his patients have a history of pregnancy loss during an intake visit, he often shares his story and acknowledges the grief of both partners. “As men, I think we take on this role of wanting to be a supporter and not wanting to be vulnerable and open up about how it’s impacting us,” he says. “But the loss impacts both [partners].”
(Scientists Are Trying to Figure Out What’s Causing Men’s Fertility to Decline.)
Fertility doctors have long recognized the emotional and physical toll of fertility treatment on female patients as they endure the effects of hormone medications, egg retrieval surgeries, and embryo transfers. Yet recently, the field is paying more attention to the male partner’s role—not only as a contributor of half a child’s DNA, but also as a hopeful future parent with his own complex emotions who can influence the success of IVF.
“The whole field is waking up to the fact that patients drop out of treatment because they’re simply too stressed,” says Alice Domar, psychologist and director of the Inception Fertility Research Institute in Houston. Not only do men provide critical support for their partners during treatment, but a growing body of research also suggests their mental health may even be connected to their sperm health.
In a July 2025 study of 718 men visiting a fertility clinic, researchers at Harvard Medical School found those who reported the highest levels of psychological stress were more likely to have a lower sperm count, with a higher percentage of the sperm showing abnormal shapes and DNA damage. Another study published in September 2025 found poor sperm motility in men in China experiencing depression, anxiety, and stress.
As such, doctors and psychologists are experimenting with new mental health interventions—from offering empathy training for health care workers to finding creative ways to include men in counseling—at a time when an estimated one in six people are struggling to conceive.
An important step in addressing men’s mental health when it comes to infertility is simply recognizing their emotional burden. In June 2026, the American Society for Reproductive Medicine (ASRM) released updated treatment guidelines on recurrent miscarriage—its first update in 14 years—explaining that men who experience pregnancy losses are also likely to suffer from the anxiety and depression that’s well documented in women.
“What’s coming out in the literature is that the stress of miscarriage and infertility in general not only affects the female partner, but that men have different ways of processing it,” says Clarisa Gracia, a reproductive endocrinologist at the University of Pennsylvania and chair of the ASRM practice committee that developed the new recommendations. “It’s important for us as physicians to recognize their pain.”
Research shows empathetic communication from doctors, even through a brief phone call, can reduce patient anxiety and distress. But most medical students historically are not trained in having these conversations with patients.
(Here Are 5 Myths About Male Fertility.)
Domar, however, has worked to teach these skills over the last decade. More recently, she created a video series to teach her company’s 135 physicians how to talk to patients about sensitive topics like infertility. Her goal was to show doctors who may be pressed for time that they can have a significant impact on patients’ wellbeing even during short visits or phone calls by acknowledging their emotions and offering thoughtful support.
In one video, fertility doctor Christopher Montville models how to call a male patient to break the news that his semen analysis revealed he had zero sperm. “I always say, ‘I know this is a shock to you, but this is just the beginning of the process. Let’s get you in to see a specialist,’” says Montville, medical director of the Tennessee Fertility Institute in Franklin. “My goal is to prevent his anxiety from taking over and to break the process into much smaller steps. I think too often physicians just focus on the numbers on a page instead of how this might impact his whole role in the pregnancy. Many of these guys take it to heart in terms of their masculinity.”
That sense of masculinity—and the stigma surrounding sharing vulnerable emotions—are factors that potentially prevent men from seeking psychological support from friends or professionals, explains Brennan Peterson, a professor of marriage and family therapy at Chapman University in Orange, California.
In January 2025, Peterson published a study showing a link between higher personal infertility stigma and depressive symptoms in both men and women. “If it's male factor, that can put a burden on the male member of a couple, where he oftentimes feels a lot of guilt and responsibility and a sense of failure,” he says. “I hear men say ‘I cannot provide something that she really wants’ or ‘I cannot help her have a child. Maybe she would be better off with another partner.’”
Peterson’s research found that more openness with others was associated with fewer symptoms of depression. “It's really important for men to be able to talk about it, but oftentimes, they don't,” he says.
Therapy can be an option during fertility treatment, but it can oftentimes be intimidating to men. To combat this, Elizabeth Grill, director of psychological services at Weill Cornell’s Center for Reproductive Medicine in New York City, changes the terminology to “psychoeducational sessions” and suggests her female patients bring along their partners. “I will often say [to the men], ‘If this is useful to you, just come back again, even just for one more session. This does not have to be weekly therapy,’” she says.
Grill notes that men typically lack the extensive social networks and close, open friendships that women have, leading them to feel more isolated. “Part of my job is helping create spaces where men can really grieve, share their fears and hopes, and get the support they need,” she says. “They're not used to talking about these kinds of emotional issues with the people they're close to. I think one of the most powerful interventions we can offer is just simply normalizing the conversation.”
Yet the lack of mental health care services available in fertility centers is an even bigger challenge in helping men open up about their feelings. One 2022 analysis of nearly 450 fertility clinic websites in the U.S. and U.K. found that only 12 percent offered integrated mental health programs, including on-site counseling services.
After experiencing the isolation of his own infertility journey and noticing the lack of mental health care available for both men and women, Doug Brown started the nonprofit Uniquely Knitted with his wife, Jesse, in 2019. The organization offers six-week virtual “process groups” to support those dealing with infertility. Men make up about 20 percent of the 50 to 100 groups the couple organizes a year. “We don't treat them as a support for their female counterpart,” says Brown. “We have them share their own story.”
In these sessions, men are prompted to talk about typical moments of fatherhood they dreamed about, such as bringing home a baby from the hospital, installing a car seat, or buying a baseball glove. “Men just break down at those things because they've never really allowed themselves to say, ‘I totally was planning on buying a LA Lakers onesie like I've always wanted,’” says Brown.
Despite the small steps made over the years, more work is still needed to address the emotional needs of men struggling with infertility. Peterson encourages doctors to remember they can have a significant impact by making sure to include men in clinic conversations. “Men still get pushed to the periphery to some degree, because treatments focus so much on women's bodies, even when it is male factor,” he says.
More importantly, Peterson advises doctors to invite men to become part of the process by sharing more information about what to expect during fertility treatment and how they can be involved.
“If medical providers could do that with men, it would provide a more supportive environment,” he says, “where they feel that they can support their partner and also get support themselves.”
