Lived Experience of Infertile Men from Fatherhood through Adoption

Male infertility is one of the reasons for accepting adopted children in Iranian families. While the discourse on infertility and child adoption predominantly focuses on women, thereby characterizing the issues as 'feminized', this study employs a descriptive phenomenological approach to explore the lived experiences of 10 infertile men in Mashhad who have adopted children. Study participants were purposefully chosen from the 'Hammasirha' Telegram group. The data obtained from the in-depth semi-structured interview, conducted form February 2022 to May 2023, underwent analysis using the Colaizzi's method. The analysis reveals three distinct main themes: 1). "Burden of Childlessness" which encompsses the ‘suffering of infertility’, ‘suffering from facing significant others’, ‘empty nest’ and ‘unsuccessful treatment’; 2). "Difficult Transition" including ‘challenges directed at oneself’, ‘challenges directed at taking action’, ‘challenges directed at others’ and the ‘challenges related to the adopted child’; and 3). "Paternity Without a Body" highlighting ‘endless concerns’, ‘development of paternal identity’, ‘the desire to have children’ and ‘modern fatherhood’. The findings revealed that in response to societal pressures and the stigma attached to being childless, these men chose adoption as a pathway to establish their paternal identity and to respond to their wives' maternal instincts. Despite ongoing concerns, they expressed satisfaction with their decision and viewed it positively.

The phenomenon of infertility encompasses a range of subsequent challenges that extend beyond medical concerns, including the psychological and social strategies individuals adopt to cope with childlessness. These strategies, particularly adoption, are subject to varying interpretations and emotional responses by men and women alike. Gender is not merely a biological distinction but a category that is deeply rooted in the social context (Miller & Scholnick, 2000), which plays a pivotal role in shaping how individuals confront the complexities of infertility and the pursuit of parenthood through alternative means such as adoption. Male infertility, which refers to the inability of a man to impregnate a woman, accounts for between 40 and 50 percent (Fisher & Hammarberg, 2017) of all infertility cases (Agarwal et al., 2020). Recent researches show that infertility often leads to men's masculinity being questioned (Hanna & Gough, 2016) and that the stigma associated with male infertility is widespread (Gannon, Glover & Abel, 2004; Ozkan et al. 2015). This stigma indicates not only individual suffering but also societal pressure men face due to involuntary childlessness (Peronace, Boivin & Schmidt, 2007). Although infertility challenges affect both infertile women and men, research in the social sciences has disproportionately focused on women, with only a small fraction addressing the impact and the experiences of male infertility (Hanna & Gough, 2020). Moreover, due to the prevailing sexist norms, the realm of biological reproduction remains a “feminized space, requiring women's commitment and work” (Hanna & Gough, 2015). The subject of adoption, particularly within the infertility literature, has been received little systematic attention within the literature (Freeark, et al. 2005). To fully understand this domain, new studies is needed that provide appropriate indights into the adoption challenges in the existing socio-cultural context, especially concerning the gender of adoptive parents.
The current study aims to present a new perspective on the challenges these men have encountered transitioning from infertility to fatherhood, by exploring the lived experiences of infertile men who have adopted children. 

The present study, employing descriptive phenomenology methodology, aims to uncover the lived experiences of infertile men who have adopted a child. The focus is on infertile Iranian men who who have become fathers through adoption. The criteria for inclusion in the study were infertility due to male causes, adoption of a child, a minimum of five years in a childless marital unions, willingness and readiness for an interview, and residence in Mashhad. Data was gathered through in-depth, semi-structured interviews centered on infertility problems, the adoption process, and subsequent post-adoption experiences. The duration of the interviews is 90 minutes on average, stating with the main question, "Where did your adoption story begin?" Follow-up questions were tailored based on prior responses, becoming increasingly specific. Purposeful sampling was utilized to select participants who could provide rich insights into the adoption experience among infertile men, acknowledging that such individuals are key informants for this research topic (Saunders, Lewis, & Thornhill, 2012). 

Analysis of data on the experiences of infertile men participating in the research were organized into three main themes: 1). the experience of infertility labeled as "Burden of Childlessness"; 2). the experiences of the adoption process termed "Difficult Transition"; and 3). the experiences of the rout to fatherhood described as "Paternity without a Body".
The "Burden of Childlessness" encompasses the ‘suffering from infertility’, ‘suffering from facing significant others’, ‘empty nest’ and ‘unsuccessful treatment’; the "Difficult Transition" covers the ‘challenges directed at oneself’, ‘challenges directed at taking action’, ‘challenges directed at others’ and the ‘challenges related to the adopted child’; and the "Paternity without a Body" involves ‘endless concerns’, ‘development of paternal identity’, ‘the desire to have children’ and ‘modern fatherhood’.

The theme of "The Burden of Infertility" reveals that men who are the source of infertility have experienced internal negative emotions and societal stigma stemming from their infertility, leading to feeling of inadequacy and deficiency in their sense of masculinity. In fact, these individuals often percieve themselves as not being "complete men", experiencing what is termed "silenced masculinity" (Abbaszadeh et al., 2023), as the prevailing societal image of masculinity is that of a man capable of procreation and fathering children. 
The analysis of participants' narratives indicates that, in accordance with Goffman (1963), both infertility and childlessness, as well as adoption of a child, lead to both personal and societal stigma for infertile men who become adoptive parents.
The findings suggest that infertile men who proceed with adopting a child confront numerous challenges, including including grappling with infertility both internally (with themselves) and externally (with their spouse and others), the dilemma of choosing between treatment or adoption, as well as the procedural complexities and the post-adoption consequences. Therefore, dealing with each of these problems necessitates specialized counseling and psychological intervention, which is especially crucial given the significance of the mental well-being of adoptive families and the enhancement of the adoption experience.

This article is based on the doctoral dissertation of the first author of the article in the field of Women's Studies, which was completed at the Faculty of Women and Family, Qom University of Religions & Denominations,. The authors of the article would like to thank all those who supported this research and the anonymous reviewers of the paper for their constructive feedbacks.