ABSTRACT
M ost women do not know the dangers of delaying child bearing. A woman's age is the biggest barrier to naturally occurring conception or success with fertility treatment. Because of misinformation and a lack of information, one in five women in the United States delays childbearing until age 35, when fertility rapidly begins to decline. As psychoanalysts and psychotherapists, we are caught in a web of analytic proscriptions, prescriptions, and taboos about imposing our personal agendas on patients. After all, our patients come to us for help with a variety of problems, not necessarily to discuss their childbearing plans. Yet, if we do not bear in mind the realities of “the biological clock,” we may collude with their denial of the realities of childbearing and cause irreparable harm. If they are not yet considering childbearing, how do we bring up such a profoundly delicate topic? If our patients have been diagnosed with infertility, how do we best help them? How do we conceptualize our role when patients are faced with extended infertility treatment and must decide when “enough is enough” or grapple with the complicated decisions surrounding the use of donor gametes or adoption? How do we negotiate our biases when they are very different from our patients’? What are the common transference and countertransference themes associated with infertility? What can infertility and reproduction teach us about ourselves?
