Approximately 15% of all couples in the reproductive age are involuntarily childless. Many of these couples consult medical experts for diagnosis and treatment but not all of them achieve the results. This paper describes a study of women's experiences of childlessness 2 years after the end of in vitro fertilization (IVF) treatment, which represents the end of infertility treatment in Swedish society. Giorgi's method, based on Husserl's phenomenology with the lifeworld theory, was used. The participants were eight women treated at the Clinic of Reproductive Medicine, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Sweden. Data were generated from transcriptions of taped interviews. Five constituents emerged from the analysis: (i) childlessness is a central issue in life, (ii) IVF is a positive and important part of life, (iii) contact with other people is not an important issue, (iv) the hope of achieving pregnancy still exists and (v) attempts to identify other central issues in life. The essence of all constituents is 'life-grief' and expresses the grief of being childless, of not reproducing, and being unable to confirm one's relationship through parenthood. The result is important in professional caring and presents a challenge to all midwives, nurses, physicians and other staff who are involved in the care of involuntarily childless women.

Despite having undergone unsuccessful IVF within the public health system, more than 75% lived with children 4-5.5 years later. This subgroup had a better quality of life, compared to those without children. Additional IVF treatment may result in increased quality of life.

BackgroundMale-factor infertility underlies approximately 30% of infertility in couples seeking treatment; of which 10% is due to azoospermia. The development of assisted reproductive technology (ART), enabling the use of epididymal or testicular sperm for fertilization of the partner's oocytes, has made biological fatherhood possible for men with obstructive azoospermia. There is limited knowledge of men's experience of their own infertility. The aim of this study was to describe men's experiences of obstructive azoospermia infertility.MethodsEight men with obstructive azoospermia, who had terminated Swedish public health system ART treatment two years previously without subsequent childbirth, were interviewed using a descriptive phenomenological method.ResultsThe essence of the phenomenon is expressed with a metaphor: climbing a mountain step by step with the aim of reaching the top, i.e. having a child and thus a family with a child. Four constituents are included (1) inadequacy followed by a feeling of redress (2) marginalisation, (3) chivalry (4) extension of life and starting a family as driving forces.ConclusionsKnowledge of men's experiences of their own infertility is important as a supporting measure to increase the quality of care of infertile couples. By adopting this facet of gender perspective in fertility treatment guidelines, care can hopefully be optimized.

Quality of life in men seems more negatively affected by involuntary infertility than reported in earlier studies.

Nyga Ê rd L, Johansson M. The experience and management of temporality in ×e cases of dementia. Scand J Occup Ther 2001; 8: 85-95. How persons with dementia may experience time, temporal problems and temporal adaptations in their everyday lives is explored. The clinical implementation process and outcome of time aid interventions in ve cases are also described. Data were collected through initial interviews with ve participants, diagnosed with dementia, and with three spouses. Thereafter, time aids were chosen for intervention in each case. During the intervention, data were collected through eldnotes and interviews, including evaluative interviews closing the interventions. The participants described experiences of temporal rhythms and extensions. Their temporal problems mainly concerned temporal relationships and coherence, and ''knowing when'' and ''how long''. They individually met the problems with strategies that aimed to overall decrease the effects of the temporal problems in general, as well as with direct and conscious attempts to address problems mainly concerning temporal orientation. When time aids were used, dif culty ''knowing when'' seemed to be most responsive to aids. However, the success of the time aid interventions was limited, as was the success of the spontaneously used strategies. Motivation and insight seemed to be important, as well as the participants' present and former attitudes to temporality. Possible implications for occupational therapy interventions are discussed, considering the clinical and piloting nature of the study.

Adjusted PGWB and SOC scores revealed a high quality of life in the adoption group. However, the group unsuccessful IVF-living without children had low quality of life scores. Quality of life appears to be independent of the outcome of IVF treatment as long as there are children in the family.

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