Psychological and social aspects of tubal infertility a longitudinal study of infertile women and their men

Abstract: All thirty women who were to undergo microsurgical treatment for tubal infertility in 1981 and their men were investigated. Over a period of 2 years four interviews were performed with the women and two with their men. A questionnaire, semistructured interviews, symptom checklist and the Eysenck Personality Inventory were used. During this longitudinal study the couples' background, current situation and emotional and social impact of the infertility problem were investigated. The psychological and social effects of the medical investigation and treatment have been described. Expectations and hopes about the future after unsuccessful surgical treatment and the need of professional psychosocial counselling have been noted. Furthermore, the extent of psychological reactions compatible with a crisis pattern has been identified and classified. Finally, overt motives for having a child have been studied.The infertile couples generally did not differ with respect to psychosocial background, current life situation, psychiatric anamnesis or personality characteristics when compared with apparently normal reference groups. Several deleterious emotional and social effects of the infertility were found both before and 2 years after the surgical treatment. The women admitted to suffering such effects more frequently than the men. The partners' feeling for each other were getting worse 2 years after the operation. There was also a tendency to a deterioration in opinions about marital relationships. Most of the mental symptoms recorded could be classified in terms of depression, guilt and isolation, which all are parts of the reactive phase of the common crisis pattern. The crisis of infertility, however, differs from the common traumatic crisis; it is more prolonged and there are often repeated crisis reactions. Negative effects on the couples' sexual life were reported by all individuals. The medical investigation and surgical treatment of infertility influenced the couples' mutual relationship and sexual life negatively.Intrapsychic and interpersonal motives of childwish were dominant among both women and men. A central motive was that a child is an ultimate expression of love between a man and a woman. The motives of the infertile couples generally did not differ from those of the reference groups.Most of the couples had difficulty in working their way through and finding a solution to their infertility problem by their own means. Relatives and friends failed to fulfil a supportive function. The importance of having the possibility of professional psychosocial counselling and support parallel with the investigation and treatment were stressed by all participants.