title: Distress in Infertile Males in Manipal-India: A Clinic Based Study.
abstract: BACKGROUND
  Being infertile comes as an overwhelming realization for couples trying to conceive. In consideration of rising rates of infertility worldwide, clinicians in India have also begun exploring this field for new possibilities, development and research. The purpose of this study was to estimate the proportion and predictors of infertility specific stress in males diagnosed with primary infertility.
  
  
  METHODS
  This cross-sectional research was conducted in an assisted reproduction center, Manipal, India, on 300 infertile married males. The tools were "semi-structured questionnaire" compiled by the authors, "ICD-10 Classification of Mental and Behavioural Disorders (Clinical Descriptions and Diagnostic Guidelines) and" Psychological Evaluation Test for infertility. Multiple logistic regression analysis was carried out on data with p-value fixed as 0.05.
  
  
  RESULTS
  The presence of stress was reported in 72% of male participants. The predictors of stress were nature and severity of their infertility diagnosis, sperm defects, urological condition and experience of corrective surgery undergone for it. Psychological stress in men was also predicted by present and past history of significant psychiatric morbidity and coping difficulties associated with it.
  
  
  CONCLUSIONS
  The stress is both a common experience and at times a clinical condition associated with deteriorating mental and physical health in men seeking fertility treatments. As a prerequisite, Indian fertility clinics need to treat stress as an identifiable condition and devise ways of addressing it at all stages of assisted conception and reproductive treatments.
authors.affiliation: Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Ansha
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Podila Satya Venkata Narasimha
authors.initials: PS
authors.lastname: Sharma
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, India; Division of Assisted Reproductive Centre, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Pratapkumar
authors.initials: P
authors.lastname: Narayan
authors.affiliation: Department of Statistics, Manipal University, Manipal, India.
authors.forename: Binu Valsalakumari Sreekumaran
authors.initials: BV
authors.lastname: Nair
authors.affiliation: Department of Clinical Psychology, School of Allied Health Sciences, Manipal University, Manipal, India.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Narayanakurup
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Praveena Joglekar
authors.initials: PJ
authors.lastname: Pai
keywords: Cross-sectional study; India; Infertility; Male; Morbidity; Psychological factors; Stress