Summary
Clinical papers strongly recommend psychosocial counseling for patients attending infertility clinics. These recommendations are at odds with studies showing that very few patients actually take-up such services. The disparity between recommendation and actual use would seem to be due to the lack of distinction between the needs of the few highly distressed patients who feel overwhelmed by their infertility and those of the average infertile couple who experience distress but cope well with it. In the former case, psychosocial counseling is likely to be beneficial, while in the latter case informal sources of help, for example, that provided through documentation, are likely to be sufficient. Unfortunately, the emphasis on psychosocial counseling for highly distressed patients in the area of infertility has left the needs of less distressed patients neglected and the potential usefulness of alternative methods of intervening with these patients unexplored.
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References
- 1.Baram D, Toutelot E, Muechler E, Huang KE. Psychosocial adjustment following unsuccessful in vitro fertilization. J Psychosom Obstet Gynecol. 1988;9:181–190. doi: 10.3109/01674828809016800. [DOI] [Google Scholar]
- 2.Daniluk JC. Infertility: Intrapersonal and interpersonal impact. Fertil Steril. 1988;49:982–290. doi: 10.1016/s0015-0282(16)59948-8. [DOI] [PubMed] [Google Scholar]
- 3.McGrade JJ, Tolor A. The reaction to infertility and the infertility investigation: A comparison of the responses of men and women. Infertility. 1981;4:7–27. [Google Scholar]
- 4.Lalos A, Lalos O, Schoultz B. The psychosocial impact of infertility two years after completed surgical treatment. Acta Obstet Gynecol Scand. 1985;65:599–604. doi: 10.3109/00016348509156369. [DOI] [PubMed] [Google Scholar]
- 5.Laffont I, Edelmann RJ. Perceived support and counselling needs in relation to in vitro fertilization. J Psychosom Obstet Gynecol. 1994;15:183–188. doi: 10.3109/01674829409025644. [DOI] [PubMed] [Google Scholar]
- 6.Paulson JD, Haarmann BS, Salerno RL, Asmar P. An investigation of the relationship between emotional maladjustment and infertility. Fertil Steril. 1988;49:258–262. doi: 10.1016/s0015-0282(16)59712-x. [DOI] [PubMed] [Google Scholar]
- 7.Shaw P, Johnston M, Shaw R. Counselling needs, emotional and relationship problems in couples awaiting IVF. J Psychosom Obstet Gynecol. 1988;9:171–180. doi: 10.3109/01674828809016799. [DOI] [Google Scholar]
- 8.Pepe MV, Byrne TJ. Women’s perceptions of immediate and long-term effects of failed infertility treatment on marital and sexual satisfaction. Family Relat. 1991;40:303–309. doi: 10.2307/585016. [DOI] [Google Scholar]
- 9.Sundby J, Olsen A, Schei B. Quality of care for infertility patients. An evaluation of a plan for a hospital investigation. Scand J Soc Med. 1994;22:139–144. doi: 10.1177/140349489402200210. [DOI] [PubMed] [Google Scholar]
- 10.Mazure CM, Takefman JE, Milki AA, Lake-Polan M. Assisted reproductive technologies. II. Psychologic implications for women and their partners. J Women’s Health. 1992;1:275–281. doi: 10.1089/jwh.1992.1.275. [DOI] [Google Scholar]
- 11.Wright J, Allard M, Lecours A, Sabourin S. Psychosocial distress and infertility: A review of controlled research. Int J Fertil. 1989;34:126–142. [PubMed] [Google Scholar]
- 12.Newton CR, Hearn MT, Yuzpe AA. Psychological assessment and follow-up after in vitro fertilization: Assessing the impact of failure. Fertil Steril. 1990;54:879–886. doi: 10.1016/s0015-0282(16)53950-8. [DOI] [PubMed] [Google Scholar]
- 13.Reading AE, Chang LC, Kerin JF. Psychological state and coping style across an IVF treatment cycle. J Reprod Infant Psychol. 1989;7:95–103. [Google Scholar]
- 14.Litt MD, Tennen H, Affleck G, Klock S. Coping and cognitive factors in adaptation to in vitro fertilization failure. J Behav Med. 1992;15:171–187. doi: 10.1007/BF00848324. [DOI] [PubMed] [Google Scholar]
- 15.Balen F, Trimbos-Kemper TCM. Long-term infertile couples: A study of their well-being. J Psychosom Obstet Gynaecol. 1993;14:53–60. [PubMed] [Google Scholar]
- 16.Berg BJ, Wilson JF. Psychological functioning across stages of treatment for infertility. J Behav Med. 1991;14:11–26. doi: 10.1007/BF00844765. [DOI] [PubMed] [Google Scholar]
- 17.Stewart DE, Boydell KM, McCarthy K, Swedlyk S, Redmond C, Cohrs W. A prospective study of the effectiveness of brief professionally-led support groups for infertility patients. Int J Psychiatr Med. 1992;22:173–182. doi: 10.2190/DRB0-3WJ0-AWDT-57AH. [DOI] [PubMed] [Google Scholar]
- 18.Domar AD, Seibel MM, Benson H. The Mind/Body program for infertility: A new behavioral treatment approach for women with infertility. Fertil Steril. 1990;53:246–249. doi: 10.1016/s0015-0282(16)53275-0. [DOI] [PubMed] [Google Scholar]
- 19.Domar AD, Zuttermeister PC, Seibel MM, Benson H. Psychological improvement in infertile women after behavioral treatment: A replication. Fertil Steril. 1992;58:144–147. [PubMed] [Google Scholar]
- 20.Goodman K, Rothman B. Group work in infertility treatment. Social Work Groups. 1984;7:79–97. doi: 10.1300/J009v07n01_07. [DOI] [Google Scholar]
- 21.Connolly KJ, Edelmann RJ, Bartlett H, Cooke ID, Lenton E, Pike S. An evaluation of counselling for couples undergoing treatment for in vitro fertilization. Hum Reprod. 1993;8:1332–1338. doi: 10.1093/oxfordjournals.humrep.a138252. [DOI] [PubMed] [Google Scholar]
- 22.Boivin J, Takefman J. Stress level across stages of in vitro fertilization in subsequently pregnant and nonpregnant women. Fertil Steril. 1995;64:802–811. doi: 10.1016/s0015-0282(16)57858-3. [DOI] [PubMed] [Google Scholar]
- 23.Boivin J, Takefman J, Tulandi T, Brender W. Reactions to infertility based on extent of treatment failure. Fertil Steril. 1995;63:801–807. [PubMed] [Google Scholar]
- 24.Boivin J, Takefman J. The impact of the in vitro fertilization-embryo transfer (IVF-ET) process on emotional, physical and relational variables. Hum Reprod. 1996;11:903–907. doi: 10.1093/oxfordjournals.humrep.a019276. [DOI] [PubMed] [Google Scholar]
- 25.Callan VJ, Hennessey JF. Emotional aspects and support in in vitro fertilization and embryo transfer programs. J Vitro Fert Embryo Transfer. 1988;5:290–295. doi: 10.1007/BF01132180. [DOI] [PubMed] [Google Scholar]