chapter  3
Prolonged infertility: psychodynamics and psychological impact of diagnosis and treatment
ByJoan Raphael-Leff
Pages 13

The actual diagnosis may follow the couple's decision to seek medical help and investigations, or be the outcome of a medical emergency such as an ectopic pregnancy. The diagnosis of infertility, sterility or subfertility may come as a long-awaited verdict following a prolonged period of medical investigations or it may come abruptly, after a medical procedure or complications. Distinction is made between sterility resulting from irreversible damage or defect, infertility and subfertility. However, in addition to the cause of infertility, in all cases it is also necessary to consider the psychological impact of involuntary childlessness on couples who are unable to fulfil their wish for a baby. Not only does infertility undermine the individual's sexual identity, but further tension is generated by the treatment situation. Autonomy and intimacy is invaded by humiliating treatment procedures, post-coital inspection and detailed sexual reports to doctors.