Male infertility and donor insemination: couples' decisions, reactions and counselling needs.

This paper reports findings of a postal survey of 205 couples belonging to the National Association for the Childless, whose infertility had been attributed to the male partner. Spontaneous resolution was seldom reported, but 36 couples had become parents by donor insemination (DI) and 28 through adoption. Almost a third of respondents had managed to resolve their childlessness. Although reasons for rejecting DI or preferring other options were offered by 60 couples, 125 had taken active steps towards it. Most of the 80 couples who had been counselled had found this helpful. Regardless of counselling, of the 76 couples who had considered whether or not to tell their children of their mode of conception, 56 (74%) stated that they had no intention of doing so. Quantitative indices from two self-report scales confirm that male infertility is commonly a source of distress, especially for the female partner. However, the data also suggest that this is not necessarily associated with chronic marital discord. Couples who had already decided for or against DI reported less distress than others. The need for mutual support may well be enhanced until the couple's quest for a child has been either achieved or abandoned.