Subject(s)
Patient Selection , Reproductive Techniques, Assisted , Humans , Infertility/therapy , Physician's RoleABSTRACT
Unexplained cases of female infertility were studied from a psychoanalytical point of view emphasizing the unconscious secondary gain from the illness. Three groups of cases were isolated: post traumatic infertility, neurotic infertility and infertility correlated with eating disorders and disturbed self image. Joint consultations between gynecologists and psychoanalysts are proposed.
Subject(s)
Fertility/physiology , Infertility, Female/psychology , Psychophysiologic Disorders , Feeding and Eating Disorders/physiopathology , Female , Humans , Neurotic Disorders/physiopathology , Pregnancy , Psychophysiologic Disorders/physiopathology , Psychophysiologic Disorders/psychology , Risk FactorsABSTRACT
Although the obstetricians have been aware of puerperal psychiatric events, atypical postnatal depression was only identified during the 1960s. Early screening is therefore required to enable preventive measures to be taken. Our prospective study was intended to uncover early signs of, or a predisposition towards, postnatal depression before postpartum discharge from the hospital. Studying a population of 186 women who had just given birth and using two tools, the self-administered questionnaires designed by Pitt and by Cox, we found a relationship between postpartum blues, evaluated with Pitt's tool on the 3rd day after delivery, and postnatal depression, evaluated 8 months later. We thus show that the postpartum blues, evaluated with Pitt's tool, especially when severe, is predictive of the subsequent development of postnatal depression.
Subject(s)
Depression, Postpartum/diagnosis , Psychological Tests , Psychometrics , Depression, Postpartum/prevention & control , Depression, Postpartum/psychology , Female , Humans , Paris , Predictive Value of Tests , Prospective StudiesABSTRACT
This study examines the reactions of 14 women to the birth of triplets. Home interviews and observations were conducted at 4 months and 1 year after the birth. The findings indicate that the triplet situation constitutes a real source of psychological stress for the women in this study. Reactions depend on two factors: individual makeup, in that some women become depressed whereas others develop defenses, and amount of support from family and friends. These variables, along with mothers' ability to overcome phantasms of abnormality generated by the exceptionality of a multiple maternity, serve to define a set of predictors of good/poor prognosis for the establishment of triplet-mother relationships.
Subject(s)
Mothers/psychology , Triplets , Adaptation, Psychological , Adult , Family/psychology , Female , Humans , Infant , Mother-Child Relations , Stress, PsychologicalABSTRACT
A new protocol was developed to provide participants of our oocyte donation program with oocytes donated by donors who were not financially rewarded, were anonymous, and fertile. Each participant provided an oocyte donor selected among fertile friends or family members. The retrieved oocytes were anonymously exchanged between phenotypically matched donor-recipient pairs. In the first 30 months of activity, we obtained 111 embryos suitable for transfer or cryopreservation from 52 retrievals, and 40 embryo transfers (ETs) were performed. Recipients received oral Estradiol-valerate and vaginal micronized progesterone. Fifteen embryos were transferred in 8 ETs conducted after donor-recipient synchronization. This resulted in four pregnancies, all ongoing (ongoing pregnancy rate 50% per transfer). Of the 96 cryopreserved embryos, 82 were thawed for ET, and 45 surviving embryos were transferred in 32 ETs. This resulted in eight pregnancies, with six ongoing or delivered (ongoing pregnancy rate 19% per transfer). The overall ongoing pregnancy rate of 25% per transfer indicates that our approach is a viable method for obtaining donated oocytes while respecting the ethical guidelines that recommended that donation of human gametes should be free, and from anonymous and fertile donors. Furthermore, guaranteeing anonymous oocyte donation had practical importance because, for many volunteer donors, it played a crucial role in their decision to donate.
Subject(s)
Bioethics , Embryo Transfer , Infertility, Female , Oocyte Donation , Oocytes , Tissue Donors , Adult , Female , Humans , Infertility, Female/etiology , SpousesABSTRACT
We present a study of how a doctor and a psycho-analyst have collaborated in an infertility clinic. We have rejected the usual division between organic and psychogenic sterility and have emphasized how in each case there is latent psychic suffering. This paper is in two parts: 1) The first describes the methodology of the joint consultation and how suitable this method is for research; 2) The second part is a synthesis of the clinical cases collected over the course of 18 months. There is always a latent psychological conflict present behind the complaint of infertility. When a doctor and a psycho-analyst are together the patient can express the preconscious or unconscious fantasy where the true significance of his symptom of sterility can be found. This may be a defence against fulfilling an Oedipus situation, or against a fantasy of parthenogenetic reproduction, or against the fear of being torn open bodily. These are given as examples.
Subject(s)
Infertility/psychology , Adult , Fear , Female , Humans , Incest , Infertility/etiology , Male , Marriage , Parent-Child Relations , Physician-Patient RelationsABSTRACT
The authors look at a consultation for contraception from the point of view of the doctor and emphasize the unusual character of this consultation: on the one hand the doctor is not asked to exercise his usual therapeutic function, and on the other hand he is put into the position where he has to be a "sexual educator", a particularly delicate position to be in especially when dealing with adolescents. The authors look then at the subject from the point of view of the patient who is consulting the doctor for contraceptive services and distinguish three stages: The patient or rather the consultee who is in full reproductive life and who asks for contraception (and its failures) in relationship to the ups and downs of her unconscious desire to have a child; the consultee at the end of her reproductive life who tries to establish a relationship of patient to doctor by avoiding a list of morbid symptoms; and particularly the adolescent whose demand for contraception is very delicate (as all medical interventions are at this age), and where the doctor finds himself in the privileged position of being able to restore individuality to the adolescent by refusing to allow the consultation to be directed by the mother.
