Abstract
Objective: To assess the socio-emotional and cultural impact related to support-seeking behavior among rural infertile couples of Punjab, Pakistan.
Methodology: This cross-sectional quantitative study included a sample of 457 respondents chosen from four rural districts of Central Punjab (Lahore, Faisalabad, Jhang, and Nankana Sahib) by using multistage sampling. The data were collected through interviews, and were analyzed by SPSS. The descriptive statistics and inferential tests were employed to determine the correlation between social challenges and the demographic variables.
Results: Majority of the respondents (47.3%) were between the ages 31-40 and had a low level of educational status (28.9%), and income (31.5%) less than 20000. They faced emotional and social challenges i.e., social disconnection, mean=4.07, jealousy, mean=3.92 at the family events due to infertility. It led to prolonged social burden on them i.e., delaying in childbirth after 1-5 years of marriage, they were stigmatized by societal pressure and social exclusion. Logistic regression model was also significant and confirmed a higher level of income (80,000) seeking more support (Odd Ratio=3.91), as compared to a low level of income (>20,000), (Odd Ratio=1.68).
Conclusion: Infertility in rural areas of Punjab is a critical intersection of medical insufficiency and socio-cultural marginalization. Infertile couples face demographic, social and emotional problems linked to support-seeking behavior, social stigma, and social exclusion, dismantling the status of infertile couples in society.

Key words: Infertility, reproductive marginalization, psychological distress, rural health.