ABSTRACT
Introduction For most people, infertility or childlessness is a devastating experience. Its implications are strongly related to and mediated by different sociocultural factors. Especially in developing countries, most societies are organised such that children are necessary for the care and maintenance of older parents. Moreover, in the absence of social security systems, older people are economically completely dependent on their children. Consequently, the inability to bear children is a tragedy and childlessness can be considered as one of the most important and underappreciated reproductive health problems in developing countries.1,2 In many cultures womanhood is defined through motherhood and infertile women usually carry the blame for their inability to conceive. Negative psychosocial consequences of childlessness are common and often severe, and relationships between couples can become very strained when children are not forthcoming.3-8 Childless women are frequently stigmatised, resulting in isolation, neglect, domestic violence and polygamy.9-17 Women who have never had a child are more likely to be divorced and separated, and childless women are also more likely to have been married more than once.18 There is no doubt that the consequences of infertility are much more severe for couples in developing countries compared with couples in developed countries.19
