Cross-culturally the expectation for couples to reproduce is an accepted norm and the inability to achieve pregnancy and bear children may be considered a violation of this cultural norm. In this context, infertility represents a crisis for both the couple and society at large. Although this concept is fairly uniform among most cultures the manner in which different cultures, ethnic groups and religious groups perceive and manage infertility may be very different. Cultural factors are important to consider since they shape one’s understanding of the world and one’s behavior. Culture is a shared way of life for a group of people and includes their beliefs, morals, laws and customs, among other things.

The literature suggests that infertility is stressful and stigmatizing across cultures. However, cultural differences may affect one’s experience of pain, one’s belief about the cause of their illness and one’s ability to communicate with the clinic staff about their medical and psychological problems. For example, many African-Americans believe that assisted reproductive techniques are unnatural and that they remove the spiritual or divine nature of creation from conception. For this reason, they may seek spiritual rather than medical assistance when trying to conceive and this may be true across all socio-economic groups since the issue if spirituality is central to this culture.

The Hispanic culture believes in the importance of family yet the people that make up this community is diverse and includes, Mexican-Americans, Cuban-Americans, Puerto Rican-Americans, among many others. Family relationships can be emotionally intense, openly affectionate and emphasize the group rather than the individual. Furthermore, respect for one’s elders, especially males, is important in this patriarchal society. Although the male figure is often described as dominant and the wives as submissive, mothers are the dominant force in the home and motherly love is felt to be stronger than wifely love. They believe that children validate the marriage so families are typically large. Like the African-American culture Hispanics are also very spiritual and may consider infertility a test of faith. In both the African-American and Hispanic cultures, access to infertility treatment may be hampered by economic barriers.

The Asian-American population is also culturally diverse and comprised of many groups including the Chinese and Japanese among many others. The concept of time and family works forwards and backwards specifically, all preceding generations and behaviors impact future generations. The man is considered the head of the family and the woman may have a much lower status. Communication style for this group may be different since it is based on age, sex, education, occupation and social status. For example, Asian-American patients may not make eye contact with the clinician out of respect for the clinician’s authority.

Religion often influences cultural factors and for this reason must also be considered when pursuing treatment for infertility. In the Jewish culture for example, procreation is felt to be an obligation and a responsibility. Yet for the some sects within this religion some protocols or reproductive options would not be sanctioned. The Roman Catholic Church most likely has the most restrictive views on the use of assisted reproductive technologies since in their view procreation cannot be separated from the relationship between parents. Therefore, children must be created by the physical union between husband and wife conceived through sexual intercourse.

In summary, one’s cultural background can strongly influence one’s response to infertility. Furthermore, it may also dictate which, if any, reproductive treatment options the couple can pursue. Most clinics have a counselor on staff (or can recommend one) who can help couples who wish to discuss the impact of cultural and religious issues on their treatment.

References:

Molock S. Racial, cultural and religious issues in infertility counseling. In: Burns L, Covington S editors. Infertility Counseling. New York: The Parthenon Publishing Group; 1999. p. 249-265.

Schenker J. Religious views regarding gamete donation. In: Siebel M, Crockin S, editors. Family building through egg and sperm donation. Sudbury: Jones and Bartlett; 1996. p.238-50.