Some Emotional Factors in Infertility

Abstract

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.

Psychoanalysis and infertility myths and realities

“…In a classic paper, Benedek et al (1953) studied six women with infertility, whose husbands had extremely low sperm counts (only one as high as 11 million, others in the 1 million to 6 million range). The women were referred for psychoanalysis to resolve ambivalent relationships with their mothers while the men were left untreated.…”

Toward the Biology of the Depressive Constellation

“…studies indicate that the "fixation" which predisposes to psychosomatic disease is closely related to the psychodynamic -factors predisposing to depression (1 8).…”

“…Describing the dynamics of such a crying fit, not caused by a commanding physiologic need such as hunger or pain, but by the thwarting of an attempt at emotional (psychologic) communication and satisfaction, is probably a hazardous speculation. I feel quite safe, 8 The term "primary narassism," as it is used here, is closely related to Alexander's concept of "surplus energy" (3), according to which "the surplus of metabolic energy is continually transformed into libido." In discussing the psychodynamic processes of the various phases of procreative growth (especially ovulation, pregnancy, and lactation) we have used the term in two diflerent ways.…”

“…)Vhat is then perceived with anger and humiliation is a sense of helplessness because one is frustrated in satisfying a wish which is felt so strongly. T h e wish for the child, the goal of procreation, remains as an aspiration of the ego invested with frustrated narcissistic energy (8).…”

The Baby Makers: An In‐Depth Single‐Case Study of Conscious and Unconscious Psychological Reactions to Infertility and ‘Baby‐Making’ Technology

“…This raises the question of whether anxiety and emotional disturbances precede or even cause infertility, or whether infertility causes psychological disturbance. For many years studies have focused on psychogenic components (Benedek et al 1953) and emotional factors (Rubenstein 1951, Taymor & Bresnick 1979 or personality traits (Platt et al 1973) in infertility. Others have studied psychological differences between fertile and nonfertile individuals (Eisner 1963) or within infertile subgroups versus fertile (Callan & Hennessey 1989).…”