Exploring undergraduates’ knowledge, attitude, and perception of male infertility in Osun State University: a mixed method study

BACKGROUND: Infertility has traditionally been seen as a female problem, causing misconceptions, stigma, and limited attention to male infertility. This study examined undergraduates' knowledge, attitudes, and perceptions of male infertility at Osun State University, Nigeria, and associated factors. METHODS: A descriptive cross-sectional mixed-methods design was used. Quantitative data came from 300 undergraduates selected by multistage sampling using a self-administered questionnaire; qualitative data came from focus group discussions. Quantitative analysis used IBM SPSS Statistics 27; qualitative analysis used thematic analysis in NVivo. Findings were integrated through a joint display matrix and narrative synthesis. RESULTS: The mean knowledge score was 7.12 ± 1.88, and the mean attitude score was 1.96 ± 1.12. Formal education on male infertility was a significant positive predictor of both knowledge (p < 0.001) and attitude (p < 0.001). Faculty affiliation (p = 0.009) and level of study (p = 0.012) were significantly associated with attitude scores. Qualitative findings showed functional understanding but culturally shaped attitudes involving marriage, masculinity, and gender roles, with women disproportionately blamed. CONCLUSIONS: Understanding was moderate but incomplete. Formal education was a strong modifiable predictor. Comprehensive, gender-inclusive reproductive health education should be integrated into university curricula, with open dialogue to reduce stigma.