Local Babies, Global Science Chapters 8,9

1. The psycho-social toll of infertility seems to hit women harder, "to be a real woman in Egypt is to have a child".

2. Men also suffer psychologically, an infertile man is viewed as "weak" and "ineffective".

3. Often wives will "cover up" or protect husbands infertility to avoid humiliation and embarrassment and assume blame for infertility themselves.

4. Virility is the "essence" of Arab masculinity.

5. A female initiated divorce (even when male infertility is the cause) is highly stigmatized in Egypt.

6. Stigma as defined by Hoffman: "an attribute that makes one different from others in a less desirable way; a person who is bad, dangerous or weak"

7. Infertility and I.V.F together is a double stigmatization.

8. Egyptian cultural roles cause women with children to discriminate against those without children.

9. The "evil eye" is a cultural norm seen across all social classes where the envy and jealousy of an infertile woman are viewed as a real threat to health and life of a woman with children.

10. I.V.F is looked upon as "shameful", a morally questionable treatment in Egypt.

11. Stigma and shame forces couples doing I.V.F into secrecy and lack of disclosure.

12. In Egypt male infertility is a constant source of shame for any man.

13. The demoralization of male infertility may "push" a man to divorce 1st wife in "exchange" for a younger 2nd wife.

14. A wife's "response" to her husband's infertility is a constant reminder of his diminished masculinity.

15. In Muslim societies barrenness is a justifiable ground for divorce.

16. Infertility effects the quality of married life, the responsibility of, blame and guilt are commonly experienced.

17. Many Egyptian men refuse to seek treatment and refuse to acknowledge their infertility.

18. Many couples worry about the future stigmatization of their children produced by I.V.F too.

19. Many couples go through the I.V.F process alone, for revealing publicly their situation is seen as a source of humiliation and exposes them to potential gossip.