Jacobs: BPSS Aspects of Infertility Flashcards
(25 cards)
What is infertility?
inability to conceive a pregnancy after one year of sexual intercourse w/o use of contraception and/or the inability to carry a pregnancy to live birth
Infertility affects (blank) in six couples
one
49% of women and 15% of men considered (blank) as the most upsetting experience of their lives (Freeman et al., 1985)
infertility
Causes of infertility: 35% (blank) 35% (blank) 20% (blank) 10% unexplained
female factor;
male factor;
combined factor
Female factors leading to infertility?
menstrual problems
blockage
structural problems
Male factors leading to infertility?
sperm
blockage
sexual functioning
Combined factors leading to infertility?
advanced age miscarriages STDs diabetes smoking alcohol/drugs weight
What are some options for infertile couples?
fertility drugs: regulate/stimulate ovulation, hormones have side effects, difficult to inject antibiotics artificial insemination surgical treatments use of third parties assisted reproductive technologies
What are some assisted reproductive technologies?
In Vitro Fertilization (IVF) Gamete Intrafallopian Transfer (GIFT) Zygote Intrafallopian Transfer (ZIFT) Tubal Embryo Transfer (TET) May be used with micromanipulation techniques Intracytoplasmic Sperm Injection (ICSI) Assisted hatching
What are some issues with medical treatment of infertility?
can be disruptive to a couple’s schedule
requires precision & can create anxiety
can pose ethical issues for the couple
How is “surprise” a factor in infertility?
bc most couples assume they will be able to have children
birth control gives a sense of control over fertility
successful people may experience a sense of “failure” for the first time
**although, some couples are relieved to get a diagnosis that explains the inability to have a child
How is “denial” a factor in infertility?
young, healthy couples may refuse fertility evaluation
may blame other partner
may question the lab/exam results
may discount/deny the importance of having a child
may distract with other activities
This is a big factor due to medical treatments & costs, diagnosis & treatment, wait times, anticipatory anxiety, failed treatments, miscarriages, emotional reactions
stress/anxiety
Does stress cause infertility?
there are no definitive studies showing that stress causes infertility!!
**educate patients on this
Why might patients feel anger with infertility?
loss of control feeling cheated out of fertility angry at "defective" body anger at past perceived "sins" angry at partner, family, friends anger over unwanted pregnancies, abortions, child abuse
It’s important to educate parents that fertility has nothing to do with (blank) & that there is no scientific connection between previous (blank) & infertility
worthiness; sins
In what ways can couples feel isolation/estrangement during infertility?
Shame may lead to isolation
Martial conflict, gender differences, may cause partners to feel estranged from one another
One partner’s wish for secrecy may isolate them
Couples may feel alienated from friends with children
Incessant and insensitive questions about fertility may lead to isolation from family
Painful feelings may lead to avoidance of pregnant women, babies and children, baby showers, holidays, etc.
May feel alienated from society, for not following traditional life course (getting married and having children)
Many suffer alone, and in silence
Why might patients feel sadness & grief associated with infertility?
Potential losses associated with infertility: natural conception, pregnancy, control, security and faith, self-worth, relationship satisfaction, hopes, your dream child, life goals, future plans, being a biological mother/father, miscarriage.
Seeing reminders of fertility
Failed treatments
Lack of support (spouse, friends, family), alienation
Sadness can turn into depression, but full-blown depression is not common
Important to grieve losses and potential losses
What kind of relationship problems present in infertility cases?
Arguing over medical treatments Arguing over expenses of treatments Different reactions to infertility Different coping styles Sex is regulated and monitored, may feel a “demand to perform,” may feel like “work” instead of fun, lacks spontaneity, postcoital tests may cause pressure
How can infertility lead to questioning religious beliefs?
“Why me?”
“Why do bad things happen to good people?”
“It’s not fair!”
“How can a ‘good God’ allow this to happen?
Infertility may be perceived as a punishment from God
“I must not be worthy to be a parent”
Being a parent can bring “status” in society, can be a marker of “adulthood.” How to get status otherwise? How to fit in?
Cultural, religious complications
Not following “the will of God”
What other reactions might couples have after experiencing infertility?
jealousy
resentment
loss of control
Comes after previous painful feelings are acknowledged and worked through
May not mean getting “over it”
Acceptance & resolution
T/F: Infertility can make people stronger, and create more intimacy in relationships
True!
How can you integrate a BPSS model into the approach to treatment for infertile patients?
educate couples about the medical aspects of infertility & fertility treatments - dispel myths about infertility
evaluate/screen for common emotional reactions
encourage social support
ask about spiritual/religious reactions
