Table 3. Selection of illustrative quotes for subthemes presented.

Analytic theme	Descriptive theme	Illustrative quote	List of study
Personal perception and beliefs	Being infertile is the same as not being a man anymore/crisis.	“Nobody just blamed me or told me anything, but I don’t think I’m even a guy, or others may think I’m not a man. I feel that I am a miserable person. I feel I’m so inept and unworthy, and people would think I can’t be on my own …” (p. 267). “A man should be able to have children … to give his wife children. So because I couldn’t I wasn’t a real man … that’s why I felt an attack on my maleness. ..t all comes down to one word … inadequate” (p. 15).	Cudmore (2005), Fahami et al. (2010), Hanna and Gough (2020), Hanna and Gough (2016) Gannon, Glover, and Abel (2004), Johansson, Hellström, and Berg (2011)
	Being a man is being a father (manhood is fatherhood) or impregnating a wife is a must for men.	“I’d say mentally it was certainly something you know that was taking its toll on me, something that was making me feel … you know when you can’t impregnate your wife, it makes me feel like less of a man. It makes me kind of feel like less of a person, and that’s something, which is core to your humanity … it’s something that’s kind of being a goal to your existence” (p. 244).	Webb and Daniluk (1999), Shirani and Henwood (2011), Hinton and Miller (2013), Herrera (2013), Dolan et al. (2017), Harlow et al. (2020), Hanna and Gough (2020)
Social and cultural norms, values, and expectations	Having children is a man mandate from society.	“The reason I wouldn’t want to tell someone was this weird stigma in our culture that, if a man doesn’t produce sperm, he’s less of a man . ..ou never want to be less of a man … . I didn’t want them to think less of me for not being able to produce sperm” (p. 244).	Throsby and Gill (2004), Inhorn (2003)
	Being infertile will be a stigma (judgment by society).	“No, he didn’t talk about it anything like as much as me, and he wouldn’t say, you know. He wouldn’t tell people about the cause. He’d just let people’s assumptions go. .. think he just couldn’t bear to talk about it” (p. 337).	Inhorn (2003), Inhorn (2004), Mumtaz, Shahid, and Levay (2013), Arya and Dibb (2016), Baranwal and Chattopadhyay (2020), Birenbaum-Carmeli and Inhorn (2009), Inhorn (2013), Tabong and Adongo (2013), Dolan et al. (2017)
	Failure to have children is resistance to God’s command.	“The bible says in genesis that we should multiply and fill the earth to ensure the continued existence of the earth” (p. 4).	Tabong and Adongo (2013)
	Between infertile man and feminism.	“I think there’s a perception—I think many people would agree with this—that infertility is a woman’s problem … . I think in terms of getting more men to participate, if you can quantify when it is a male problem, if you can make a stronger case there and then the wife or the partner can then use that as a way to persuade their husband or spouse hopefully” (p. 10).	Malik and Coulson (2008), Harlow et al. (2020), Carmeli and Birenbaum-Carmeli (1994)