Male infertility, different from female infertility, is characterized by anxiety about sexual adequacy, potency, and manliness. This assault on a man's sense of self revives feelings of competition, castration, and experiences of developmental trauma. In this article we review the literature on male factor infertility and its relationship to psychogenic impotence and to psychological fertility in the larger sense. We also discuss spermatogenesis, sperm donation, and the emotional implications for men of the new reproductive technologies. Finally, we consider the effect on the couple relationship and the value of psychological treatment.