Clinical Review ABC of subfertility

Counselling

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7422.1038 (Published 30 October 2003) Cite this as: BMJ 2003;327:1038
  1. Alison Bagshawe,
  2. Alison Taylor

    Introduction

    Subfertility usually affects a person's capacity to function normally in close personal relationships, socially, and at work. Many couples find that facing the problem of subfertility, and coping with the investigations and treatments can cause anxiety, stress, and depression. Demands and pressures may be placed on subfertile couples by different cultural, religious, and familial attitudes towards parenthood and childlessness. These factors can also affect the way each individual feels about and responds to the problem.

    Subfertility and couples' relationships

    Tensions and conflicts within close relationships are common, and many couples experience a degree of sexual dysfunction in their attempts to conceive. A history of termination of pregnancy, recurrent miscarriages, sexually transmitted infections, or sterilisation can all become a source of conflict. One or both partners may feel guilty or a have sense of failure, and as a result misunderstandings and blame can occur, which may cause the breakdown of relationships. Men and women usually experience subfertility and its treatment in different ways, and lengthy treatments may have an impact on work and on domestic and social lives.


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    Dealing with the pressures of subfertility and the investigations and treatments can cause anxiety,stress, and depression

    The role of the counsellor

    Opening up clearer communication

    The counsellor's task is to deal with the stress of the situation by exploring what has led to it, and to help find ways of opening up clearer communication between partners. Advice is not given on how the situation should be resolved, but instead the counsellor asks the couple what they would like to change and helps them explore how each of them might do this.

    Counselling aims to clarify the needs arising from the impact of fertility problems on the person's emotional, psychological, and social life. Supporting and encouraging the expression …

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