A young couple is shining a light on their complex seven-year journey to falling pregnant, in the hopes of breaking the stigma linked to male infertility.

Manu Fisi’ihoi, 32, has lifted the lid sense of failure he grappled with - almost going as far as letting his wife Hannah, 29, go - when he learned their struggle to have a child was on his side.

It comes as research shared by Fertility New Zealand shows infertility impacts one in four Kiwis in their lifetime - and for a heterosexual couple, an infertility issue is as equally likely to impact a male, as female.

Te Whatu Ora has further highlighted that for around one third of couples seen, male infertility is the main issue.

As more couples start families older, data from Fertility New Zealand estimates 1,750 babies - one in 30 births every year are due to fertility treatments.

The Fisi’ihois were in their early twenties when they received life-changing news they would need to fight hard for their now five-month-old daughter Melenenah. 

It had followed a happy year of marriage, and with many close friends and family conceiving - starting a family for the Auckland-based couple was a natural next step.

But when months ticked by, and when nothing happened, they sought medical advice and were referred to a fertility specialist.

They received an initial diagnosis of male factor infertility following multiple tests showing Manu only had 12 viable sperms, despite leading a healthy lifestyle. 

"All those 12 ended up getting frozen so we still luckily have those, but any subsequent test they did - they weren't able to find any," Hannah said.

That was at the end of 2016, and in the coming six years the couple would face two rounds of IVF fertility treatment, six embryo transfers resulting in two failures, one chemical pregnancy, and two miscarriages before Melenenah's safe arrival in January. 

It posed unique challenges for the pair, but Manu struggled the most with the diagnosis initially.

"First thing that came to mind was feeling like I wasn't going to be able to have a family one day, feeling very inadequate, I felt less of a man."

He said the weight of the diagnosis took him to a place where he no longer wanted to be married to Hannah because he couldn't provide her with a child.

"I just wanted her to have her dream come true to become a mother and I didn't necessarily care what happened for me - it was more of I want my best friend to be able to enjoy the best things of this life".

But while their relationship was tested, over time Manu's mindset shifted.

"A lot of it was just me saying well you know I want to be married to you and yes while I would love to have a child with you if I don't, I still choose you," Hannah said.

They hope by sharing their story, they'll remove shame linked with male infertility.

Manu said it's important that other men understand it's okay to have feelings similar to what he did - and his feelings of inadequacy have helped him become a little more passionate about IVF.

But he said there's little representation of men going through infertility and this needs to change.

"There's no advocates or even people who are Maori or Pasifika available to just talk you through it," Manu said.

He is also mindful that telling others to be strong when times are tough doesn't hold a lot of substance - and said he has never told anyone struggling with IVF they'll fall pregnant.

"I feel like it is one of the worst things you can say to people. Although you want to give them hope I feel like it is more just being a listener".

The couple also urges others to enjoy the moments they do have with their significant other.

"Embrace what life does give you, do your absolute best to look at positive things, and be able to still allow yourself to feel the emotions," Manu said,

For Hannah, the start of the IVF treatment in particular took a toll.

While Manu never felt mixed feelings towards loved ones, Hannah felt herself become someone she was not when others became pregnant.

She said she could barely interact with her pregnant younger sister - who she grew up best friends with - when she started with IVF.

Hannah closed herself off - unfollowing friends on social media, didn't attend baby showers, and couldn't look at other women's stomachs.

"I couldn't understand why until my sister gave birth. I recognised I don't have an issue with the babies but pregnancy in itself is a trigger for me, I am not too sure why," Hannah said.

But her friends didn't hold it against her and still shared their children with her, and supported her through her pregnancy - while her sister's daughter is now a mini-version of herself.

"While I do have a lot of regret about the way I handled things in the moment I guess I felt I had to be selfish because I couldn't bring myself to be fake for one but also it was more harmful for me to be around those situations than not," Hannah said.

The Fisi’ihois regularly now find themselves in disbelief after fighting to have their daughter for so long.

"Your body doesn't quite understand that the fight is over if that makes sense so you're kind of left in this sort of limbo state where you finally have everything that you wanted," Hannah said.

Manu describes being a father as one of the most prestigious titles in the world.

"To now have this sense of urgency to be a better provider, better protector to have these bursts of energy I didn't know I had. I just feel honoured I get to be a father to her".

The Fisi’ihois are not the only ones to speak out on male infertility, with broadcasting personality Jay-Jay Harvey revealing the struggle she and her husband Dom's battle to have a child in 2018. 

Meanwhile, top Australian biochemist Dr Libby Weaver is pushing for men to be brought into the pregnancy wellness conversation.

She said a lot of focus is placed on the women's health preconception, despite the father contributing half the DNA. 

Dr Weaver highlights selenium, along with zinc plays a huge role in the health of the sperm. 

"New Zealand soils are deficient in selenium. One of our own real food sources is Brazil nuts and if we are not eating those then we'll essentially need to supplement it," she said. 

Fertility Associates gynaecologist Phill McChesney said there is support out there for men struggling with infertility but agrees more could be done to bring them into the conversation. 

He said when people come to see them in the clinic - they're very keen for men and women to be involved equally, but it appears men are left out at times in preconception counselling.

When it comes to successfully falling pregnant, McChesney adds a lot of it is about lifestyle and many of us could do better with these choices.

"The important ones for men are really about stopping smoking or recreational drugs. Limiting the amount of alcohol they're consuming, increasing to a good amount of exercise, thinking about obesity...and perhaps a reduction in caffeine as well".

Fertility New Zealand CEO Lydia Hemingway is optimistic more people are talking about their health but infertility in general often goes unspoken and leaves people feeling isolated.

"There is such a focus particularly when you are younger about not getting pregnant and things associated with that but actually it's really important to be aware of your fertility and what you can be doing to increase your chances for when you are ready to start a family," she said. 

Hemingway said men should not be embarrassed and to seek help if they've got concerns or want more information about preconception health.

 The nationwide registered charity provides support groups, a helpline, workshops - and urges families to reach out for support.

For more information go to https://www.fertilitynz.org.nz