A comprehensive examination of infertility stigma among fertile and infertile women in the United States

Infertility impacts 1 in 6 couples; however, having children is a social norm, potentially stigmatizing infertile individuals. This research expands previous qualitative and small-scale studies with a large-scale survey of both fertile and infertile women’s societal perceptions of female and male infertility stigma as well as infertile women’s internalized experiences of stigma. A national, cross-sectional survey. 327 women were recruited through an e-newsletter in March 2019; no incentive was provided. Eligible participants were ages 18 to 59, identified as women, and lived in the USA. After providing informed consent, participants completed an online survey to assess societal perceptions of female and male infertility stigma. The survey also assessed infertile women’s internalized experiences of stigma and emotions. The data were analyzed using one-sample and independent sample t-tests and bivariate correlations; the power for these analyses was excellent (.99). Participants ranged in age from 18 to 59 (M = 34.11, SD = 6.64). The majority identified as heterosexual (95%) and had a partner (81%). Infertility was defined as a diagnosis of infertility or 12 months of unprotected sex without becoming pregnant; 33% of the participants were infertile. An examination of societal perceptions of infertility stigma revealed that both fertile (M = 2.90, SD = 0.76) and infertile women (M = 2.76, SD = 0.81) felt that female infertility was stigmatized (the means were statistically higher than the midpoint of the 5-point scale; fertile women, t(217) = 4.89*; infertile women, t(108) = 5.48*). Fertile (M = 2.56, SD = 0.73) and infertile women (M = 2.49 SD = 0.71) did not believe male infertility was stigmatized (the means were not statistically higher than the midpoint; fertile women, t(217) = -0.15, ns; infertile women, t(108) = 0.95, ns). A comparison of societal perceptions of female and male infertility stigma revealed that both fertile and infertile women felt that female infertility stigma was significantly higher than male infertility stigma (fertile women: t(217) = 5.96*; infertile women: t(108) = 4.80*). Infertile women indicated feeling internalized stigma, as the mean (M = 4.18, SD = 0.84) was significantly higher than the midpoint of the 5-point scale, t(108) = 3.04*. Internalized stigma was associated with feeling afraid (r = .25*), uncertain (r = .22*), anxious (r = .24*), stressed (r = .36*), ashamed (r = .46*), and guilty (r = .52*). Despite the increased awareness of infertility and emergence of new technologies increasing treatment success, infertility stigma persists, particularly for women. The results suggest that women believe infertile women are stigmatized, and there is greater stigma for infertile women than men. Further, infertile women report feeling stigmatized, which is related to negative emotions. Infertility stigma puts strain on relationships, may lead individuals to hide their diagnoses from friends or family and delay or avoid treatment. In turn, this could lead to worse prognoses for these patients.