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Objectives: In Indian society infertility and sexual dysfunction are stigmatized characteristics. The aim of the study was to explore which label couples who have both complaints, prefer to describe their situation, and whether gender differ occur in this preference., Methods: A total of 40 couples - all clients of the reproductive health clinic of the King Edward Memorial Hospital in Pune because of problems with infertility and sexual dysfunction - participated in this study. Data were collected by means of interviews., Results: The findings show that sexual activity decreased as the number of childless years increased. However, the interspouse-relationship gets stronger and more supportive. The couples never revealed their sexual dysfunction to others. When the husband was sexually dysfunctional, the couples preferred to label their situation as 'infertility' in order to avoid stigma., Conclusion: Issues that are related to sexual dysfunction, sexual behavior, inter-spouse relationship and communication are important aspects into the reality of an infertile couple's life., Practice Implication: In planning the treatment clinicians should give more attention to the specific cultural context of these aspects.

In order to understand the problems of unwanted infertility in a country--the Gambia--where the desire for children and the fertility is very high, a population-based survey was undertaken. All infertile women in 24 randomly selected enumeration areas were assessed. The study included a review of the problems faced and coping mechanisms employed by infertility clients and types of health care available for infertile couples in the different types and levels of the formal and traditional health system. Half of the infertile couples failed to seek formal health care, and they have to reach a certain level of care in order to properly managed. Alternative care is often sought. Child fostering is also a frequent solution to childlessness. In-depth interviews revealed that traditional care like healers and spiritual leaders are frequently consulted long before formal health care. This delay could be a problem in those cases where infertility is caused by infections.

Findings of an anthropological study of socio-cultural aspects of infertility among members of the matrilineal ethnic group Macua in the north of Mozambique are presented. Infertile women apply various strategies to have a child. Traditional healers are visited much more often than the modern hospital, and the explanations the infertile women themselves give for their infertility more often originated from the traditional healers than from the hospital staff. Almost all of the interviewed women commit adultery in the hope to conceive. Some of them apply fostering as a partial solution for childlessness. The Macua infertile women experience various consequences due to their infertility, of which exclusion from certain social activities and traditional ceremonies is perceived as a very problematic one. The matrilineal kinship system means that the husband and his family do not mistreat and repudiate her. Infertility must be considered as a serious reproductive health problem in Mozambique. For the long term preventive measures may be more influential than curative one. The findings of this study can be used to elaborate culturally sensitive health education programmes.