Knowledge, Attitudes, and Practices Regarding Male Infertility: A Cross-Sectional Study Among Infertile Couples Visiting Fertility Clinics in Indonesia’s Urban Areas

Background In many countries, the stereotype that women are to blame for infertility in relationships remains prevalent, even though approximately half of the cases are caused by male factors. This study aimed to determine the knowledge, attitudes, and practices of infertile couples in urban areas with regard to male infertility. Methods A web-based survey was conducted among infertile couples who visited fertility clinics in three cities in Indonesia. Sociodemographic information and knowledge, attitudes, and practices regarding male infertility were obtained through self-reported questionnaires. Composite scores were categorized using Bloom’s cut-off, relationships between domains were assessed using Goodman-Kruskal gamma, and sociodemographic predictors in each domain were analyzed using logistic regression. Results A total of 378 participants completed the questionnaire (201 men, 177 women); 66.9% had good knowledge, 72.5% had positive attitudes, and 70.1% had good practices. Knowledge was associated with attitudes (γ = 0.280, p = 0.016), but not with practices (γ = 0.140, p = 0.186). Attitude was associated with practice (γ = 0.251, p = 0.031). Among all participants, 82% visited an obstetrician-gynecologist first. A total of 39.9% of fertility examinations were conducted first on the wife, 11.4% on the husband, and 48.7% on both. A monthly income above IDR 10 million was the only sociodemographic factor that was associated with a good level of knowledge (OR = 1.93, 95% CI 1.21–3.06). Men and women did not show significant differences in these three domains. Conclusion Most participants in our study at fertility clinics in urban areas visited an obstetrician-gynecologist first rather than a urologist and the wife was investigated first far more often than the husband. This is despite 95.8% agreed that both partners should be evaluated together. This gap indicates a problem within the healthcare system rather than the couple’s own knowledge or attitude.