1The Emotional Distress of Infertility This paper is being provided to the Class of 2007 as an example of a Master’s Project paper, and should be used solely by those students. This paper is not intended for publication or for any other use. The author retains all copyright privileges. Please respect the author’s work and use this material as intended.2Abstract Background: A couple is considered medically infertile after 12 months of regular unprotected intercourse. The cause of their infertility can be due to a number of factors, although making the actual determination can be very difficult. Regardless of cause, many of these couples will undergo various treatment regimens inorder to conceive and most of those couples will experience some level of emotional distress. Not only realizing, but also addressing the psychological aspects of infertility has much clinical significance. Therapeutic intervention and influence may help prevent the development of emotional disorders associated with an infertility diagnosis and treatment. Objective: The inability to achieve a pregnancy and a diagnosis of infertility can cause many emotional responses such as guilt, anxiety, depression, frustration, and grief. Recent studies have been performed indicating the significant impact of an infertility diagnosis and treatment on the psychological well being of both women and men. Many of these individuals have shown higher scores on anxiety and depression scales, psychological evaluation tests indicating the need for psychological support, higher levels of grief, and decreased marital and sexual satisfaction levels. Women tend to experience more distress than men. The women reported more concerns than men in the areas of life satisfaction, sexuality, self blame, self-esteem and avoidance of others. How each individual copes with the diagnosis and treatment has shown to have an impact on their stress levels as well. Those that utilized more effective coping behaviors (social networks such as family, friends, other infertile women, and professional support) were found to prevent the prolonged sense of threat and reduced emotional stress. Studies have shown3those infertile individuals receiving psychosocial support tend to have higher levels of coping skills and overall are able to tolerate their situation better. Discussion: Healthcare providers treating infertility need to not only be aware of the distress, but also address the difficulties and provide necessary counseling or referrals. The studies have shown women tend to have a more stressful experience and more problems coping. The medical staff needs to offer assistance in overcoming negative emotions and help patients in achieving better self-control and social support. Conclusion: Medical providers have the responsibility of treating the entire patient and not just the diagnosis. By providing infertile patients the support and tools to undergo the course(s) of treatment, there could be a high possibility of decreasing stress, having a greater success in treatment, and allowing them overall better feelings about themselves and the treatment. Introduction Having a child and creating a family are largely considered some of the greatest accomplishments and joys in the lives of a couple. This newly created human being resulted from much planning for some couples and much surprise for others. The ability to conceive a child can not readily be predicted for a healthy couple, and will only be known once the couple engages in regular intervals of unprotected intercourse. For some couples, even with careful planning and many attempts of becoming pregnant, they are unable to conceive a child. A couple is medically defined as being infertile when there is a failure to conceive a child after 12 months of regular unprotected intercourse (Anderson et al., 2002). It has been indicated by the World Health Organization that 8% to 12% of couples worldwide experience infertility (Hsu and Kuo, 2002). It is important to note4that infertility is simply a decrease in the ability to conceive, not the inability to conceive, which would indicate sterility. Within the United States, it is estimated that 7.1% of married couples have fertility problems (Mindes et al., 2003). In a recent year, 9.3 million US women or 15% of all females of reproductive age had ever used some type of infertility services (medical advice, tests, medications, surgery, etc.) (Mindes et al., 2003). Whether or not the prevalence of infertility has increased over the past few decades appears to be of conflicting data. The percentages and actual numbers of have risen, but some resources attribute this to utilization and availability of medical services, the media, and public awareness (Mindes et al., 2003). It is extremely difficult to determine if there has been an actual change in infertility prevalence due to lack of data beyond two decades, medical advancements and availability, and individual admission of infertility. Any number of factors can be the cause of infertility. Some of these can be medically confirmed, and when possible, resolved. Making a definitive diagnosis of the cause can be extremely difficult if the patient presents asymptomatic and medical testing is negative. Therefore, some cases remain unexplained and ultimately unresolved. Some of the known causes of infertility are listed in Table 1, below (DeCherney and Nathan, 2003). Table 1. Possible Etiologies of Infertility Male Factor Endocrine disorders Abnormal motility Hypothalamic disorders Absent cilia Pituitary failure Hyperprolactinemia Abnormal hyperplasia Exogenous androgens Varicocele Thyroid disorders Antibody formation Anatomic disorders Sexual dysfunction5 Congenital absence of vas deferens Retrograde ejaculation Obstruction of vas deferens Impotence Congenital abnormalities Decreased libido of ejaculatory system Abnormal spermatogenesis Chromosomal abnormalities Mumps orchitis Cryptorchidism Chemical or radiation exposure Ovulatory Factor Central defects Metabolic disease Chronic hyperandrogenemic anovulation Thyroid disease Hyper prolactinemia Liver disease Hypothalamic insufficiency Renal disease Pituitary insufficiency Obesity Peripheral defects Androgen excess Gonadal dysgenesis Premature ovarian failure Ovarian tumor Ovarian resistance Pelvic Factor Infection