FUNCTIONAL STERILITY as a diagnosis refers to the somatic effects of psychodynamic factors resulting in a more or less persistent inhibition of the propagative function in individuals whose functional capacity for sexual intercourse is adequate. 6 Psychoanalytical studies of women often reveal data in regard to childbearing. Psychoanalytical studies of men, however, hardly touch on the problem of fertility, as if it were tacitly assumed that man's fertility, belonging to the realm of organic physiology, lies outside of the territory of psychological investigation. Even in this project, in which at the onset we assumed that the subjects of our investigation were fertile women whose husbands are sterile, we did not plan an investigation of the emotional motivations of the infertility of these men. Our aim was to investigate the emotional factors which inhibit conception by artificial insemination at the time of ovulation in women whose wish for pregnancy and motherhood appears obvious. We hoped in this way to secure more concrete data about emotional factors which might inhibit or facilitate conception.successful procedure in animals, resulting in pregnancy in more than 99 per cent of single inseminations. The successful impregnation of women by artificial insemination, however, occurs only after three to twenty inseminations, or in from 4 per cent to 30 per cent of the attempts; the average number of such procedures before pregnancy is eight. These data include only those instances of artificial inseminations which were attempted during the presumptive fertile periods as determined by basal body temperatures, vaginal smears, changes in the cervical mucus, and in hormone excretion. Artificial insemination is not attempted until after three months of observation of the patient to determine whether or not she ovulates and develops a secretory endometrium premenstrually. It has been observed that following artificial insemination the first few times, women, who had previously ovulated regularly, failed to ovulate for varying lengths of time. To the psychoanalyst, it cannot be surprising that artificial insemination, a mechanized, "unnatural" technique, as a substitute for an action of intimacy and highly emotional gratification, is a traumatizing procedure; that it naturally leads to the inhibition of its own aim.This study is limited to six cases; all of them were in treatment by one of the investigators* for varying lengths of time for the purpose of achieving pregnancy by artificial insemination. After several unsuccessful attempts, psychotherapy was recommended. There was no further selection of the cases in regard to indication and suitability for psychotherapy; no pre-* Boris B. Rubenstein, M.D.
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