Human Embryo Cryopreservation: Psychological follow-up
Luisa Barón, E. Polak de Fried. ICER Instituto Medico, Buenos Aires, Argentina
Objective: To analize the main psychological features of patients during the different stages of cryopreservation: a) when deciding to enter the cryopreservation program; b) while the embryos are kept frozen; c) at the time of the embryo transfer; d) in case of no pregnancy, fantasies of the couple; e) in case of pregnancy, fantasies about the child to be born; f) at the moment of the birth and; g) follow-up of the mother/father/infant relationship and the child’s psychological evolution.
Materials and Methods: 47 couples who enter the embryo cryopreservation program between March and July 1994. All couples were interviewed by a psychiatrist member of our professional team. They were subject to psychoanalytical interview with a limited objective technique. Follow-up was performed during the different stages: monthly during the pregnancy and bimonthly after birth.
Results: a) Thirty-nine (82.98%) couples expressed that they agreed to cryopreserve mainly because the procedure increased their chances of success without undergoing another cycle of controlled ovarían hyperstimulation and also due to the economic benefits of the option. Eight patients (17.02%) stated that they agreed to cryopreserve due to the deep frustration after an unsuccessful previous attempt during which they had refused cryopreservation. Among the reasons not to accept freezing, these patients mentioned religious and ethical motives, fear of malformations and lack of determination even with all the information provided. b) During the time of cryopreservation, 94% of the patients referred difficulties to spontaneously inquire about the embryos until the moment they express their wish of undergoing embryo tranfer. c) At the moment of the transfer, the main motive of anxiety among couples was fear that the method would cause the embryos not to be viable (85%). d) Those couples who did not achieve pregnancy had the fantasy that failure was due to cryopreservation. They express preference to transfer fresh embryos in the future and cryopreserve again the exceeding ones. e) When the pregnancy occurred, fantasies about the malformation appeared at the beginning of the pregnancy and towards the middle of the last three-month period before the birth. f) In all cases the anxiety diminished after seeing the child was normal, g) The families were normally constituted and the children presented a normal development.
Conclusiones: Couples undergoing cryopreservation had different fantasies and anxieties which did not seem to affect the normal psychological evolution of children and parents up to present observation.