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. 2003 Dec;20(12):485–494. doi: 10.1023/B:JARG.0000013648.74404.9d

Psychogenic Infertility—Myths and Facts

Tewes H Wischmann 1
PMCID: PMC3455307  PMID: 15035547

Abstract

Purpose: The hypothesis of this review is that the role of psychological factors as the sole cause of infertility is generally overrated.

Methods: A review is given of studies concerning the influence of psychological factors on the development of infertility.

Result: A prevalence of psychogenic infertility of 10–15 per cent must be discussed critically. A value of approximately 5 per cent is more realistic. Equating unexplained infertility with psychogenic infertility is not justified. A definition of psychogenic infertility according to the German guidelines Psychosomatics in Reproductive Medicine is presented. Spontaneous pregnancies following adoption or the decision to remain childless are the absolute exception. The association of stress and infertility in humans is still unclear. For many women the effect of infertility and notably of medical therapy is a considerable emotional stress. This may make psychosocial counseling necessary in certain cases

Conclusions: An exclusive psychological/psychodynamical point of view on the complexity of infertility is as inadequate as a strictly somatic point of view. Infertility should always be treated as a psychosomatic entirety.

Keywords: Emotional distress, psychogenic infertility, psychosocial factors, spontaneous pregnancies, unexplained infertility

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REFERENCES

  • 1.Wright J, Allard M, Lecours A, Sabourin S. Psychosocial distress and infertility: A review of controlled research. Int J Fertil. 1989;58:731–737. [PubMed] [Google Scholar]
  • 2.Stanton AL, Lobel M, Sears S, DeLuca RS. Psychosocial aspects of selected issues in women's reproductive health: Current status and future directions. directions JC onsultC linP. 2002;70:751–770. doi: 10.1037//0022-006x.70.3.751. [DOI] [PubMed] [Google Scholar]
  • 3.Jeker L, Micioni G, Ruspa M, Zeeb M, Campana A. Wish for a child and infertility: Study on 116 couples. I: Interview and psychodynamic hypotheses. Int J Fertil. 1988;33:411–420. [PubMed] [Google Scholar]
  • 4.Batstra L, van de Wie HBM, Schuiling GA. Opinions about “unexplained subfertility.”. J Psychosom Obstet Gynaecol. 2002;23:211–214. doi: 10.3109/01674820209074674. [DOI] [PubMed] [Google Scholar]
  • 5.Stanton AL, Dunkel-Schetter C. Psychological adjustment to infertility: An overview of conceptual approaches. In: Stanton AL, Dunkel-Schetter C, editors. Infertility Perspectives From Stress and Coping Research. New York: Plenum; 1991. pp. 3–16. [Google Scholar]
  • 6.Greil AL. Infertility and psychological distress: A critical review of the literature. Soc Sci Med. 1997;45:1679–1704. doi: 10.1016/s0277-9536(97)00102-0. [DOI] [PubMed] [Google Scholar]
  • 7.Burns LH, Covington SH. Psychology of infertility. In: Burns LH, Covington SH, editors. In Infertility Counseling A Comprehensive Handbook for Clinicans. New York: Parthenon; 1999. pp. 3–25. [Google Scholar]
  • 8.van Balen F. The psychologization of infertility. In: Inhorn MC, van Balen F, editors. In Infertility Around the Globe. Berkeley: University of California press; 2002. pp. 79–98. [Google Scholar]
  • 9.Deutsch H. A Psychoanalytical Interpretation, Vol 2, Motherhood. New York: Grune and Stratton; 1945. The Psychology of Women. [Google Scholar]
  • 10.Benedek T. Infertility as a psychosomatic defense. In 8th Annual Meeting of the American Society for the Study of Sterility, 1952. [DOI] [PubMed]
  • 11.Jacobson E. A case of sterility. Psychoanal Quart. 1946;12:330–350. [PubMed] [Google Scholar]
  • 12.Langer M. Maternidad y sexo. Buenos Aires: Ediciones Paides; 1953. [Google Scholar]
  • 13.Christie GL. The psychogenic factor in infertility. Austr NZ J Psyciatry. 1994;28:378–390. doi: 10.3109/00048679409075863. [DOI] [PubMed] [Google Scholar]
  • 14.Allison GH. Motherhood, motherliness, and psychogenic infertility. Psychoanal Quart. 1997;66:1–17. [PubMed] [Google Scholar]
  • 15.Bydlowski M. Facteurs psychologiques dans l'infertilite feminine. Gynecol Obstet Fertil. 2003;31:246–251. doi: 10.1016/s1297-9589(03)00038-9. [DOI] [PubMed] [Google Scholar]
  • 16.Bydlowski M, Dayan-Lintzer M. A psycho-medical approach to infertility: “Suffering from sterility.”. J Psychosom Obst Gynecol. 1988;9:139–151. [PubMed] [Google Scholar]
  • 17.Leuzinger-Bohleber M. The “Medea fantasy.” An unconscious determinant of psychogenic sterility. Int J Psychoanal. 2001;82:323–345. doi: 10.1516/0020757011600849. [DOI] [PubMed] [Google Scholar]
  • 18.Rubenstein BB. An emotional factor in infertility: A psychosomatic approach. Fertil Steril. 1951;2:80–86. doi: 10.1016/s0015-0282(16)30428-9. [DOI] [PubMed] [Google Scholar]
  • 19.Crosignani PG, Collins J, Cooke ID, Diczfalusy E, Rubin B. Recommendations of the ESHRE workshop on “Unexplained Infertility.”. Hum Reprod. 1993;8:977–980. doi: 10.1093/oxfordjournals.humrep.a138177. [DOI] [PubMed] [Google Scholar]
  • 20.Eisner BG. Some psychological differences between fertile and infertile women. J Clin Psychiatry. 1963;19:391–395. doi: 10.1002/1097-4679(196310)19:4<391::aid-jclp2270190403>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  • 21.Templeton AA, Penney GC. The incidence, characteristics, and prognosis of patients whose infertility is unexplained. Fertil Steril. 1982;37:175–182. doi: 10.1016/s0015-0282(16)46035-8. [DOI] [PubMed] [Google Scholar]
  • 22.Pepperell RJ, McBain JC. Unexplained infertility: A review. Brit J Obstet Gynaecol. 1985;92:569–580. doi: 10.1111/j.1471-0528.1985.tb01394.x. [DOI] [PubMed] [Google Scholar]
  • 23.Collins JA. Unexplained infertility. In: Seibel MM, editor. Infertility—A Comprehensive Text. Norwalk: Appleton and Langer; 1990. pp. 259–272. [Google Scholar]
  • 24.Thonneau P, Marchand S, Tallec A, Ferial ML, Ducot B, Lansac J, Lopes P, Tabaste JM, Spira A. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988–1989) Hum Reprod. 1991;6:811–816. doi: 10.1093/oxfordjournals.humrep.a137433. [DOI] [PubMed] [Google Scholar]
  • 25.Collins JA, Crosignani PG. Unexplained infertility: A review of diagnosis, prognosis, treatment efficacy and management. Int J Gynecol Obstet. 1992;39:267–275. doi: 10.1016/0020-7292(92)90257-j. [DOI] [PubMed] [Google Scholar]
  • 26.Shushan A, Eisenberg VA, Schenker JG. Subfertility in the era of assisted reproduction: Changes and consequences. Fertil Steril. 1995;64:459–469. doi: 10.1016/s0015-0282(16)57777-2. [DOI] [PubMed] [Google Scholar]
  • 27.Sundstrom I, Ildgruben A, Hogberg U. Treatment-related and treatment-independent deliveries among infertile couples, a long-term follow-up. up ActaO bstetG ynecolS. 1997;76:238–243. [PubMed] [Google Scholar]
  • 28.Keye WR. Medical aspects of infertility for the counselor. In: Burns LH, Covington SH, editors. Infertility Counseling. A Comprehensive Handbook for Clinicans. New York: Parthenon; 1999. pp. 27–46. [Google Scholar]
  • 29.Miller JH, Weinberg RK, Canino NL, Klein NA, Soules MR. The pattern of infertility diagnoses in women of advanced reproductive age. Am J Obstet Gynecol. 1999;18:952–957. doi: 10.1016/s0002-9378(99)70331-5. [DOI] [PubMed] [Google Scholar]
  • 30.Wischmann T, Stammer H, Scherg H, Gerhard I, Verres R. Psychological characteristics of infertile couples: A study by the “Heidelberg Fertility Consultation Service.”. Hum Reprod. 2001;16:1753–1761. doi: 10.1093/humrep/16.8.1753. [DOI] [PubMed] [Google Scholar]
  • 31.Cahill DJ, Wardle PG: Management of infertility. BMJ 2002;325:28–32 [DOI] [PMC free article] [PubMed]
  • 32.Adamson GD, Baker VL. Subfertility: Causes, treatment and outcome. Best Pract Res Clin Obstet Gynaecol. 2003;17:169–185. doi: 10.1016/s1521-6934(02)00146-3. [DOI] [PubMed] [Google Scholar]
  • 33.Haxton MJ, Fleming R, Hamilton MP, Yates RW, Black WP, Coutts JR. “Unexplained infertility” results of secondary investigations in 95 couples. Br J Obstet Gynaecol. 1987;94:539–542. doi: 10.1111/j.1471-0528.1987.tb03147.x. [DOI] [PubMed] [Google Scholar]
  • 34.Marrero MA, Ory SJ. Unexplained infertility. infertility CurrO pinO bstetG. 1991;3:211–218. [PubMed] [Google Scholar]
  • 35.Lobo RA. Unexplained infertility. J Reprod Med. 1993;38:241–249. [PubMed] [Google Scholar]
  • 36.La Sala GB, Cittadini E. Unexplained infertility. Acta Europ Fertil. 1994;25:7–17. [PubMed] [Google Scholar]
  • 37.Randolph JF. Unexplained infertility. Clin Obstet Gynecol. 2000;43:897–901. doi: 10.1097/00003081-200012000-00019. [DOI] [PubMed] [Google Scholar]
  • 38.Aboulghar MA, Mansour RT, Serour GI, Al I. H. Diagnosis and management of unexplained infertility: An update. Arch Gynecol Obstet. 2003;267:177–188. doi: 10.1007/s00404-002-0300-0. [DOI] [PubMed] [Google Scholar]
  • 39.Pantesco V. Nonorganic infertility: Some research and treatment problems. Psychol Rep. 1986;58:731–737. doi: 10.2466/pr0.1986.58.3.731. [DOI] [PubMed] [Google Scholar]
  • 40.Apfel RJ, Keylor RG. Psychoanalysis and infertility—myths and realities. Int J Psychoanal. 2000;83:85–103. doi: 10.1516/0020757021601702. [DOI] [PubMed] [Google Scholar]
  • 41.Adler JD, Boxley RL. The psychological reactions to infertility: Sex roles and coping styles. Sex Roles. 1985;12:271–279. [Google Scholar]
  • 42.Edelmann RJ, Connolly KJ. Psychological aspects of infertility. Brit J Med Psychol. 1986;59:209–219. doi: 10.1111/j.2044-8341.1986.tb02686.x. [DOI] [PubMed] [Google Scholar]
  • 43.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]
  • 44.O'Moore AM, O'Moore RR, Harrison RF. Psychosomatic factors in patients with hyperprolactinemia. Obstet Gynecol. 1983;55:591–608. [PubMed] [Google Scholar]
  • 45.Callan VJ. The personal and marital adjustment of mothers and of voluntarily and involuntarily childless wives. J Marriage Fam. 1987;49:847–856. [Google Scholar]
  • 46.Callan VJ, Hennessey JF. The psychological adjustment of women experiencing infertility. Brit J Med Psychol. 1988;61:137–140. doi: 10.1111/j.2044-8341.1988.tb02772.x. [DOI] [PubMed] [Google Scholar]
  • 47.Morse C, Dennerstein L. Infertile couples entering an in vitro fertilization programme: A preliminary survey. J Psychosom Obst Gyn. 1985;4:207–219. [Google Scholar]
  • 48.Stauber M: Psychosomatik der sterilen Ehe, 2nd edn. Berlin, Grosse, 1988
  • 49.Schmidt P, Wischmann T, Gerhard I. Partnerbeziehung bei unerfülltem Kinderwunsch. Z Med Psychol. 1994;2:64–71. [Google Scholar]
  • 50.Dunkel-Schetter C, Lobel M. Psychological reactions to infertility. In: Stanton AL, Dunkel-Schetter C, editors. Infertility Perspectives from Stress and Coping Research. New York: Plenum; 1991. pp. 29–57. [Google Scholar]
  • 51.Brkovich AM, Fisher WA. Psychological distress and in-fertility: Forty years of research. J Psychosom Obst Gyn. 1998;19:218–228. doi: 10.3109/01674829809025700. [DOI] [PubMed] [Google Scholar]
  • 52.Eugster A, Vingerhoets AJ. Psychological aspects of in vitro fertilization: A review. Soc Sci Med. 1999;48:575–589. doi: 10.1016/s0277-9536(98)00386-4. [DOI] [PubMed] [Google Scholar]
  • 53.Henning K, Strauß B. Psychological and psychosomatic aspects of involuntary childlessness: State of the research at the end of the 1990's. In: Strauß B, editor. Involuntary Childlessness Psychological Assessment, Cunseling and Psychotherapy. Seattle, WA: Hogrefe & Huber; 2002. pp. 3–18. [Google Scholar]
  • 54.Berg BJ, Wilson JF. Psychiatric morbidity in the infertile population: A reconceptualisation. Fertil Steril. 1990;53:654–661. [PubMed] [Google Scholar]
  • 55.Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Köhn F-M. Treatment-related stresses and depression in couples under-going assisted reproductive treatment by IFV. Andrologia. 1999;31:27–35. [PubMed] [Google Scholar]
  • 56.Wischmann T, Verres R, Stammer H, Scherg H: "Heidelberger Kinderwunsch-Sprechstunde"-Psychosomatische Beratung von Paaren mit unerfülltem Kinderwunsch: Teil-projekte "Fortbildung" und "Beratung." Schlussbericht für das Bundesministerium für Bildung und Forschung (FKZ: 01KY9606), 2001
  • 57.Boivin J. A review to psychosocial interventions in infertility. Soc Sci Med. 2003;57:2325–2341. doi: 10.1016/s0277-9536(03)00138-2. [DOI] [PubMed] [Google Scholar]
  • 58.Glover L, Gannon K, Sherr L, Abel PD. Distress in sub-fertile men: A longitudinal study. J Reprod Infant Psychol. 1996;14:23–36. [Google Scholar]
  • 59.Domar AD, Seibel MM, Benson H. The mind/body program for infertility: A new behavioral treatment approach for woman with infertility. Fertil Steril. 1990;53:246–249. doi: 10.1016/s0015-0282(16)53275-0. [DOI] [PubMed] [Google Scholar]
  • 60.Domar AD, Clapp D, Slawsby EA, Dusek J, Kessel B, Freizinger M. Impact of group psychological interventions on pregnancy rates in infertile women. Fertil Steril. 2000;73:805–811. doi: 10.1016/s0015-0282(99)00493-8. [DOI] [PubMed] [Google Scholar]
  • 61.Boivin J, Kentenich H. Guidelines for Counselling in Infertility. Oxford: Oxford University Press; 2002. [DOI] [PubMed] [Google Scholar]
  • 62.Strauß B, Bettge S, Bindt C, Brähler E, Felder H, Gagel D, Goldschmidt S, Henning K, Ittner E, Kentenich H, Ningel K, Stammer H, Verres R, Wischmann T, Yüksel E. Psychosomatik in der Reproduktionsmedizin. Leitlinien. Reproduktionsmedizin. 2000;16:326–331. [Google Scholar]
  • 63.Seibel MM, Taymor M. Emotional aspects of infertility. Fertil Steril. 1982;37:137–145. doi: 10.1016/s0015-0282(16)46029-2. [DOI] [PubMed] [Google Scholar]
  • 64.Karahasanoglu A, Barglow P, Growe G. Psychological aspects of infertility. J Reprod Med. 1972;9:241–247. [PubMed] [Google Scholar]
  • 65.Mozley PD. Psychophysiologic infertility: An overview. Clin Obstet Gynecol. 1976;19:407–417. doi: 10.1097/00003081-197606000-00014. [DOI] [PubMed] [Google Scholar]
  • 66.Lindheim SR, Legro RS, Morris RS, Vijod MA, Lobo RA, Paulson RJ, Sauer MV. Altered responses to stress in women undergoing in-vitro fertilization and recipients of oocyte donation. Hum Reprod. 1995;10:320–323. doi: 10.1093/oxfordjournals.humrep.a135935. [DOI] [PubMed] [Google Scholar]
  • 67.Mai FM. Interesting sexual cases: Psychogenic infertility. Med Aspects Hum Sex. 1971;5:26–32. [Google Scholar]
  • 68.Hull MG, Glazener CMA, Kelly NJ, Conway DI, Foster PA, Hinton RA, Coulson C, Lampert PA, Watt EM, Desai KM. Population study of causes, treatment, and outcome of infertility. BMJ. 1985;291:1693–1697. doi: 10.1136/bmj.291.6510.1693. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 69.Rantala ML, Koskimies AL. Sexual behavior of infertile couples. Int J Fertil. 1988;33:26–30. [PubMed] [Google Scholar]
  • 70.Freeman EW, Boxer AS, Rickels K, Tureck RW, Mastroianni L. Psychological evaluation and support in a program of in vitro fertilisation and embryo transfer. Fertil Steril. 1985;43:48–53. doi: 10.1016/s0015-0282(16)48316-0. [DOI] [PubMed] [Google Scholar]
  • 71.Baram D, Tourtelot E, Muechler E, Huang K-E. Psychosocial adjustment following unsuccessful in vitro fertilisation. J Psychosom Obst Gyn. 1988;9:181–190. [Google Scholar]
  • 72.Demyttenaere K, Nijs P, Ramon W. Wie neurotisch sind infertile Paare? Zur Problematik von psychischen und sexuellen Störungen bei der IVF. Sexualmedizin. 1988;11:620–624. [Google Scholar]
  • 73.Sabatelli RM, Meth RL, Gavazzi SM. Factors mediating the adjustment to involuntary childlessness. Fam Relat. 1988;37:338–343. [Google Scholar]
  • 74.Downey J, Yingling S, McKinney M, Husami N, Jewelewics R, Maidman J. Mood disorders, psychiatic symptoms, and distress in women presenting for infertility evaluation. Fertil Steril. 1989;52:425–432. doi: 10.1016/s0015-0282(16)60912-3. [DOI] [PubMed] [Google Scholar]
  • 75.Eckert H, Sobeslavsky I, Held H-J: Psychische Merkmale bei Paaren mit unerfülltem Kinderwunsch vor IVF. In Psychosoziale Aspekte von Fruchtbarkeitsstörungen, S Goldschmidt, E Brähler (eds), Bern, Huber, 1998, pp 27–49
  • 76.Tuschen-Caffier B, Florin I, Krause W, Pook M. Cognitive-behavioral therapy for idiopathic infertile couples. Psychother Psychosom. 1999;68:15–21. doi: 10.1159/000012305. [DOI] [PubMed] [Google Scholar]
  • 77.Denber HCB. Psychiatric aspects of infertility. J Reprod Med. 1978;20:23–29. [PubMed] [Google Scholar]
  • 78.Arronet GH, Bergquist CA, Parekh MV. The influence of adoption on subsequent pregnancy in infertile marriage. Int J Fertil. 1974;19:159–162. [PubMed] [Google Scholar]
  • 79.Wischmann T: Ungewollte Kinderlosigkeit-Ein brennendes Problem: Aus psychologischer Sicht. In Adoption Positionen, Impulse, Perspektiven, H Paulitz (ed), München, Beck, 2000, pp 133–143
  • 80.Hennelly B, Harrison RF, Kelly J, Jacob S, Barrett T. Spontaneous conception after a successful attempt at in vitro fertilization/intracytoplasmic sperm injection. Fertil Steril. 2000;73:774–778. doi: 10.1016/s0015-0282(99)00609-3. [DOI] [PubMed] [Google Scholar]
  • 81.Nijs P, Koninckx PR, Verstraeten D, Mullens A, Nicasy H. Psychological factors of female infertility. Europ J Obstet Gynecol Reprod Biol. 1984;18:375–379. doi: 10.1016/0028-2243(84)90060-1. [DOI] [PubMed] [Google Scholar]
  • 82.Dunphy BC, Kay R, Robinson N, Cooke ID. The placebo response of subfertile couples to attending a tertiary referral centre. Fertil Steril. 1990;54:1072–1075. doi: 10.1016/s0015-0282(16)54007-2. [DOI] [PubMed] [Google Scholar]
  • 83.Collins JA, Burrows EA, Willan AR. The prognosis for live birth among untreated infertile couples. Fertil Steril. 1995;64:22–28. [PubMed] [Google Scholar]
  • 84.Harrison RF. Unexplained infertility. In: Rodrýguez-Armaz O, Hédon B, Daya S, editors. Infertility and Contraception. A Textbook for Clinical Practice. New York: Parthenon; 1998. pp. 73–77. [Google Scholar]
  • 85.Kemeter P, Fiegl J. Adjusting to life when assisted conception fails. Hum Reprod. 1998;13:1099–1105. doi: 10.1093/humrep/13.4.1099. [DOI] [PubMed] [Google Scholar]
  • 86.Pandian Z, Bhattacharya S, Templeton A. Review of unexplained infertility and obstetric outcome: A 10 year review. Hum Reprod. 2001;16:2593–2597. doi: 10.1093/humrep/16.12.2593. [DOI] [PubMed] [Google Scholar]
  • 87.Connolly KJ, Edelmann RJ, Cooke ID, Robson J. The impact of infertility on psychological functioning. J Psychosom Res. 1992;36:459–468. doi: 10.1016/0022-3999(92)90006-n. [DOI] [PubMed] [Google Scholar]
  • 88.ESHRE Capri Workshop Group Guidelines to the prevalence, diagnosis, treatment and management of infertility. Hum Reprod. 1996;4:1775–1807. [Google Scholar]
  • 89.Keye WR. Psychosexual responses to infertility. Clin Obstet Gynecol. 1984;27:760–766. doi: 10.1097/00003081-198409000-00024. [DOI] [PubMed] [Google Scholar]
  • 90.Menning BE. The emotional needs of infertile couples. Fertil Steril. 1980;34:313–319. doi: 10.1016/s0015-0282(16)45031-4. [DOI] [PubMed] [Google Scholar]
  • 91.Stammer H, Wischmann T, Verres R. Counselling and couple therapy for infertile couples. Fam Process. 2002;41:111–122. doi: 10.1111/j.1545-5300.2002.40102000111.x. [DOI] [PubMed] [Google Scholar]
  • 92.Burns LH, Covington SH (eds): Infertility Counseling. A Comprehensive Handbook for Clinicans. New York, Parthenon, 1999
  • 93.Strauß B (ed): Involuntary Childlessness. Psychological Assessment, Counselling and Psychotherapy. Seattle, WA, Hogrefe & Huber, 2002
  • 94.Xiao E, Ferin M. Stress-related disturbances of the menstrual cycle. Ann Med. 1997;29:215–219. doi: 10.3109/07853899708999339. [DOI] [PubMed] [Google Scholar]
  • 95.Wasser SK. Stress and reproductive failure: An evolutionary approach with applications to premature labor. Am J Obstet Gynecol. 1999;180:272–274. doi: 10.1016/s0002-9378(99)70716-7. [DOI] [PubMed] [Google Scholar]
  • 96.Yamamora D, Reid R. Psychological stress and the reproductive system. Semin Reprod Endocrinol. 1990;8:65–73. [Google Scholar]
  • 97.Ferin M. Stress and the reproductive cycle. J Clin Endocrinol Metab. 1999;84:1768–1774. doi: 10.1210/jcem.84.6.5367. [DOI] [PubMed] [Google Scholar]
  • 98.Cohen L. Acurrent perspective of pseudocyesis. Am J Psychol. 1982;139:1140–1144. doi: 10.1176/ajp.139.9.1140. [DOI] [PubMed] [Google Scholar]
  • 99.Sydenham A. Amenorrhea at Stanley camp, Hong Kong, during interment. BMJ. 1946;2:159. [PubMed] [Google Scholar]
  • 100.Boivin J, Takefman JE. Stress level across stages of in-vitro-fertilization in subsequently pregnant and nonpregnant women. Fertil Steril. 1995;64:802–810. doi: 10.1016/s0015-0282(16)57858-3. [DOI] [PubMed] [Google Scholar]
  • 101.Tennen H, Affleck G, Mendola R. Causal explanations for infertility: Their relationship to control appraisals and psychological adjustment. In: Stanton AL, Dunkel-Schetter C, editors. Infertility Perspectives From Stress and Coping Research. New York: Plenum; 1991. pp. 109–131. [Google Scholar]
  • 102.Klonoff-Cohen H, Chu E, Natarajan L, Sieber W. A prospective study of stress among women undergoing IVF or gamete intrafallopian transfer. Fertil Steril. 2001;76:675–687. doi: 10.1016/s0015-0282(01)02008-8. [DOI] [PubMed] [Google Scholar]
  • 103.Morse CA, van Hall EV. Psychosocial aspects of infertility: A review of current concepts. J Psychosom Obstet Gynaecol. 1987;6:157–164. [Google Scholar]
  • 104.Demyttenaere K, Nijs P, Evers-Kiebooms G, Koninckx PR. Personality characteristics, psychoendocrinological stress and outcome of IVF depend upon the etiology of infertility. Gynecol Endocrinol. 1994;8:233–240. doi: 10.3109/09513599409023626. [DOI] [PubMed] [Google Scholar]
  • 105.Merari D, Feldberg D, Shitrit A, Elizur A, Modan B. Psychosocial characteristics of woman undergoing in vitro fertilization: A study of treatment outcome. Israel J Obstet Gynecol. 1996;7:65–72. [Google Scholar]
  • 106.Facchinetti F, Matteo ML, Artini GP, Volpe A, Genazzani AR. An increased vulnerability to stress is associated with a poor outcome of in vito fertilization-embryo transfer treatment. Fertil Steril. 1997;67:309–314. doi: 10.1016/S0015-0282(97)81916-4. [DOI] [PubMed] [Google Scholar]
  • 107.Gallinelli A, Roncaglia R, Matteo ML, Ciacciol I, Volpe A, Facchinetti F. Immunological changes and stress are associated with different implantation rates in patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2001;76:85–91. doi: 10.1016/s0015-0282(01)01826-x. [DOI] [PubMed] [Google Scholar]
  • 108.Tarabusi M, Matteo ML, Volpe A, Facchinetti F. Stress-response in male partners of women submitted to in vitro fertilization and embryo transfer. Psychother Psychosom. 2000;69:275–279. doi: 10.1159/000012406. [DOI] [PubMed] [Google Scholar]
  • 109.Sanders KA, Bruce NW. Aprospective study of psychological stress and fertility in women. Hum Reprod. 1997;12:2324–2329. doi: 10.1093/humrep/12.10.2324. [DOI] [PubMed] [Google Scholar]
  • 110.Milad MP, Klock SC, Moses S, Chatterton R. Stress and anxiety do not result in pregnancy wastage. Hum Reprod. 1998;13:2296–2300. doi: 10.1093/humrep/13.8.2296. [DOI] [PubMed] [Google Scholar]
  • 111.Csemiczky G, Landgren BM, Collins A. The influence of stress and state anxiety on the outcome of IVF-treatment: Psychological and endocrinological assessment of Swedish women entering IVF-treatment. Acta Obstet Gynecol Scand. 2000;79:113–118. doi: 10.1034/j.1600-0412.2000.079002113.x. [DOI] [PubMed] [Google Scholar]
  • 112.Sanders KA, Bruce NW. Psychosocial stress and treatment outcome following assisted reproductive technology. Hum Reprod. 1999;14:1656–1662. doi: 10.1093/humrep/14.6.1656. [DOI] [PubMed] [Google Scholar]
  • 113.Beerendonk C, Hendriks J, Scheepers H, Braat DDM, Merkus J, Oostdam B, Van Dop P. The influence of dietary sodium restriction on anxiety levels during an in vitro fertilization procedure. J Psychosom Obst Gyn. 1999;20:97–103. doi: 10.3109/01674829909075582. [DOI] [PubMed] [Google Scholar]
  • 114.Thiering P, Beaurepaire J, Jones M, Saunders D, Tennant C. Mood state as a predictor of treatment outcome after in vitro fertilisation/embryo transfer technology. J Psychosom Res. 1993;37:481–491. doi: 10.1016/0022-3999(93)90004-y. [DOI] [PubMed] [Google Scholar]
  • 115.Vartiainen H, Saarikoski S, Halonen P, Rimon R. Psychosocial factors, female fertility and pregnancy: Aprospective study-Part I: Fertility. J Psychosom Obstet Gynecol. 1994;15:67–75. doi: 10.3109/01674829409025631. [DOI] [PubMed] [Google Scholar]
  • 116.Visser A, Haan G, Zalmstra H, Woulters I. Psychosocial aspects of in vitro fertilization. J Obstet Gynecol. 1994;15:35–43. doi: 10.3109/01674829409025627. [DOI] [PubMed] [Google Scholar]
  • 117.Stoléru S, Cornet D, Vaugois P, Fermanian J, Magnin F, Zerah S, Spira A. The influence of psychological factors on the out-come of the fertilization step of in vitro fertilization. J Psychosom Obst Gyn. 1997;18:189–202. doi: 10.3109/01674829709080688. [DOI] [PubMed] [Google Scholar]
  • 118.Brähler E, Felder H: Auswirkungen und Belastungen durch medizinische Behandlung bei unerfülltem Kinderwunsch. Projekt: Zentrale Datenauswertung/Metaanalyse. End report for the German Ministry of Education and Science (FKZ 01KY9601/6), 2000, pp 102–199.
  • 119.Harlow CR, Fahy UM, Talbot WM, Wardle PG, Hull MG. Stress and stress-related hormones during in-vitro fertilization treatment. Hum Reprod. 1996;11:274–279. doi: 10.1093/humrep/11.2.274. [DOI] [PubMed] [Google Scholar]
  • 120.McMahon CA, Ungerer JA, Beaurepaire J, Tennant C, Saunders D. Anxiety during pregnancy and fetal attachment after in-vitro fertilization conception. Hum Reprod. 1997;12:176–182. doi: 10.1093/humrep/12.1.176. [DOI] [PubMed] [Google Scholar]
  • 121.Slade P, Emery J, Lieberman BA. A prospective, longitudinal study of emotions and relationships in in-vitro-fertilization treatment. Hum Reprod. 1997;12:183–190. doi: 10.1093/humrep/12.1.183. [DOI] [PubMed] [Google Scholar]
  • 122.Verhaak CM, Smeenk JMJ, Eugster A, van Minnen A., Kremer JA, Kraaimaat FW. Stress and marital satisfaction among women before and after their first cycle of in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril. 2001;76:525–531. doi: 10.1016/s0015-0282(01)01931-8. [DOI] [PubMed] [Google Scholar]
  • 123.Pesch U, Weyer G, Tauber H-D. Coping mechanism in infertile women with luteal phase insufficiency. J Psychosom Obst Gyn. 1989;10:15–23. [Google Scholar]
  • 124.Takefman JE, Brender W, Boivin J, Tulandi T. Sexual and emotional adjustment of couples undergoing infertility investigation and the effectiveness of preparatory information. J Psychosom Obstet Gynecol. 1990;11:275–290. [Google Scholar]
  • 125.Strauß B, Appelt H, Bohnet HG, Ulrich D. Relationship between psychological characteristics and treatment outcome in female patients from an infertility clinic. J Psychosom Obst Gynecol. 1992;13:121–133. [Google Scholar]
  • 126.Demyttenaere K, Bonte L, Gheldof M, Vervaeke M, Meulemann C, Vanderschurem D, D'Hooghe T. Coping style and depression level influence outcome in in vitro fertilization. Fertil Steril. 1998;69:1026–1033. doi: 10.1016/s0015-0282(98)00089-2. [DOI] [PubMed] [Google Scholar]
  • 127.Domar AD, Zuttermeister PC, Friedman R. The relationship between distress and conception in infertile women. J Am Med Womens Assoc. 1999;54:196–198. [PubMed] [Google Scholar]
  • 128.Chiba H, Mori E, Morioka Y, Kashiwakura M, Nadaoka T, Saito H, Hiroi M. Stress of female infertility: Relations to length of treatment. Gynecol Obstet Invest. 1997;43:171–177. doi: 10.1159/000291848. [DOI] [PubMed] [Google Scholar]
  • 129.Schover L, Collins RL, Richards S. Psychological aspects of donor insemination: Evaluation and follow-up of recipient couples. Fertil Steril. 1992;57:583–590. doi: 10.1016/s0015-0282(16)54904-8. [DOI] [PubMed] [Google Scholar]
  • 130.Brähler E, Felder H, Hölzle C: Auswirkungen und Belastungen durch medizinische Behandlung bei unerfülltem Kinderwunsch. Projektschlußbericht für das BMBF im Förderschwerpunkt "Fertilitätsstörungen" (FKZ 01K9311), 1997
  • 131.Hellhammer DH, Hubert W, Freischem CW, Nieschlag E. Male infertility: Relationships among gonadotropins, sex steroids, seminal parameters and personality attitudes. Psychosom Med. 1985;47:58–66. doi: 10.1097/00006842-198501000-00006. [DOI] [PubMed] [Google Scholar]
  • 132.Hurst KM, Dye L, Rutherford AJ, Oodit R. Differential coping in fertile and sub-fertile males attending an assisted conception unit: A pilot study. J Reprod Infant Psychol. 1999;17:189–198. [Google Scholar]
  • 133.Pook M, Krause W, Röhrle B. Coping with infertility: Distress and changes in sperm quality. Hum Reprod. 1999;14:1487–1492. doi: 10.1093/humrep/14.6.1487. [DOI] [PubMed] [Google Scholar]
  • 134.Harrison RF, Callan VJ, Hennessey JF. Stress and semen quality in an in vitro fertilization programme. Fertil Steril. 1987;48:633–636. [PubMed] [Google Scholar]
  • 135.Clarke RN, Klock SC, Geoghegan A, Travassos DE. Relationship between psychological stress and semen quality among in-vitro fertilization patients. Hum Reprod. 1999;14:753–758. doi: 10.1093/humrep/14.3.753. [DOI] [PubMed] [Google Scholar]
  • 136.Poland ML, Giblin PT, Ager JW, Moghissi KS. Effect of stress on semen quality in semen donors. Int J Fertil. 1986;31:229–231. [PubMed] [Google Scholar]
  • 137.Hammond KR, Kretzer PA, Blackwell RE, Steinkampf MP. Performance anxiety during infertility treatment: Effect on semen quality. Fertil Steril. 1990;53:337–340. doi: 10.1016/s0015-0282(16)53291-9. [DOI] [PubMed] [Google Scholar]
  • 138.Dhillon R, Cumming CE, Cumming DC. Psychological well-being and coping patterns in infertile men. Fertil Steril. 2000;74:702–706. doi: 10.1016/s0015-0282(00)01511-9. [DOI] [PubMed] [Google Scholar]
  • 139.Negro V. A. Stress and other environmental factors affecting fertility in men and women: Overview. Environ Health Perspect. 1993;101(Suppl2):59–64. doi: 10.1289/ehp.93101s259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 140.Berg BJ. A researcher's guide to investigating the psychological sequelae of infertility: Methodological considerations. J Psychosom Obst Gyn. 1994;15:147–156. doi: 10.3109/01674829409025640. [DOI] [PubMed] [Google Scholar]
  • 141.Taylor PJ, Leader A, Pattinson HA. Unexplained infertility: A reappraisal. Int J Fertil. 1995;30:53–56. [PubMed] [Google Scholar]
  • 142.Decker A. Psychogenic Infertility: Fact or fiction? Med Aspects Hum Sex. 1972;6:168–175. [Google Scholar]

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