title: Severe male infertility after failed ICSI treatment--a phenomenological study of men's experiences.
abstract: BACKGROUND
  Male-factor infertility underlies approximately 30% of infertility in couples seeking treatment; of which 10% is due to azoospermia. The development of assisted reproductive technology (ART), enabling the use of epididymal or testicular sperm for fertilization of the partner's oocytes, has made biological fatherhood possible for men with obstructive azoospermia. There is limited knowledge of men's experience of their own infertility. The aim of this study was to describe men's experiences of obstructive azoospermia infertility.
  
  
  METHODS
  Eight men with obstructive azoospermia, who had terminated Swedish public health system ART treatment two years previously without subsequent childbirth, were interviewed using a descriptive phenomenological method.
  
  
  RESULTS
  The essence of the phenomenon is expressed with a metaphor: climbing a mountain step by step with the aim of reaching the top, i.e. having a child and thus a family with a child. Four constituents are included (1) inadequacy followed by a feeling of redress (2) marginalisation, (3) chivalry (4) extension of life and starting a family as driving forces.
  
  
  CONCLUSIONS
  Knowledge of men's experiences of their own infertility is important as a supporting measure to increase the quality of care of infertile couples. By adopting this facet of gender perspective in fertility treatment guidelines, care can hopefully be optimized.
authors.affiliation: Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden. marianne.ak.johansson@vgregion.se
authors.forename: Marianne
authors.initials: M
authors.lastname: Johansson
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Hellström
authors.forename: Marie
authors.initials: M
authors.lastname: Berg
mesh_terms: D000328:Adult; D001294:Attitude to Health; D053713:Azoospermia / Q000523:psychology* / Q000628:therapy; D004644:Emotions; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D012747:Sexual Partners / Q000523:psychology; D020554:Sperm Injections, Intracytoplasmic; D017211:Treatment Failure