Luisa Baron | Médica psiquiatra especialista en Fertilidad

Psychological aspects of the fertile female partner in cases of male infertility

L Barón, G. Rey Valzacchi, L Blanco, S Pasqualini Halitus Instituto Médico, Buenos Aires, Argentina

Objective: to perform a psychological follow up in order to assess the mam emotional issues fertile women undergo when facing the infertility of their partners and to evaluate the importance of holding individual psychological interviews with these women.

Design: prospective

Materials and Method: the first hundred couples presentmg male infertility and with témale partners under 35 years oíd with no evident pathology who entered the ICSI (89/100) and Donor Insemination (DI) (11/100) programs of the Department of Andrology of Halitus Instituto Medico of Argentina after December 1996 were included. The study evaluated the data collected during joint psychological interviews (Jl) with limited objectives, the replies of female patients to an anonymous questionnaire (AQ) and during individual psychological interviews (II). Data from all three sources were compared. When appropriate, the replies given before and after the first treatment were compared.

Results: the mam emotional-issues mentioned were: a) Optimism towards the procedure: Ist attempt: 89% of the patients were optimistic . There were no significant differences between the replies provided in the Jl, AQ and II. Before the 2″d attempt: figures decreased to 75%, 49% and 25% respectively. b) Sharing einotions with others: 84% of the patients did not talk to their husbands because they feared they will hurt their feelings, 22% talked to friends and 81% did not talk with their families in order to protect their partner’s image. c) Aggressive attitude towards partners: Ist attempt: 20% of the subjects expressed having these feelings during the Jl but figures increased to 45% and 89% for the AQ and the II respectively. 2nd attempt: figures were 25% , 86% and 92% for Jl, AQ and II. d) Self- Perception: (II, 2″d attempt): patients expressed more isolation (85%), higher level of anguish (79%), more aggression (72%), depression (56%), to be more concerned about their own biological clock (65%); and greater anger about having to expose their bodies to an ART proceding (87%). e) Fantasies about being unfaithful to their husbands (II and 2mi attempt): 79% of the patients expressed these fantasies, 82% mentioned dreaming or remembering previous boyfriends. Only 37% of the women acknowledged these fantasies in the AQ. f) Sexual desire: ls t treatment: patients expressed feeling less attracted to their partners (17% in the Jl, 51 % in the AQ; and 60% in the II) and these figures increased to 20%, 60% and 81 % at the time of the 2nd attempt. g) Need of individual psychological support: 97% of the patients regarded II as bemg “highly necessary”. h) Feelings about their husbands being concern about them: 86% of the patients felt their husbands supported them at the time of the Jl, 80% in the AQ and 72% in the II . At the time of the 2nd ttempt, the figures decreased to 31% , 26%, and 4% respectively. i) Feelings towards the medical team (II). at the time of the first attempt 75% of the patients felt they were taken into consideration but the number decreased to 30% during the 2nd attempt.

Conclusions: our results suggests that the feelings of fertile women with infertlle partners vary after a first unsuccessful attempt and are hard to express in front of other people or during joint psychological interviews. Anonymous questlonnaires do not reflect them accurately either. It was at the time of individual inteviews when women felt more comfortable to fully express their feelings and emotions. Therefore, we conduele that it is necessary to include routine individual interviews as part of the treament of these couples.

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