Fertility and Assisted Reproduction

Infertility, including the inability to carry a pregnancy to term, can deeply affect the emotional and psychological well being of both women and men.

Fertility, in our culture and others, stands for productivity, growth, and continuity. For most people, reproduction is a basic expectation of life, and to have a child is to continue the human life cycle. It is the renewal of life; it is a type of immortality. Because fertility and childbearing are deeply rooted in our psyches and in our culture, the inability to have a child can be a powerful threat to identity. Specifically, the experience of infertility is often defined as a "life crisis." Its impact on self-image, marital and sexual relationships, and relationship with family and friends is significant. To become a parent is regarded by many as the most significant rite of passage into adulthood. As such, infertility brings with it many real or potential losses: the loss of self-esteem, the loss of a dream, the loss of close relationships, financial losses, and the loss of a sense of self as a healthy sexual being.

Society places a high premium on family, and women have traditionally assumed the biologic roles of giving birth and nurturing children. A number of studies suggest that women exhibit more emotional distress related to infertility than men. Depression, anxiety, anger, and guilt are common psychological responses to infertility. These conditions can be exacerbated as men and women feel unable to predict or control treatment outcomes.

Infertility, as well as habitual pregnancy loss, touches people deeply. It threatens their identity as capable adults, and can have significant ongoing psychological effects. Addressing the psychological components of infertility can not only help individuals and couples in developing more effective coping strategies, but can also help them make important decisions about treatment as well as other parenting options.

Please also see the section entitled "Reproductive Psychiatry".