Tewes Wischmann

Private Practice for Supervision and Analytical Psychology

The unfulfilled desire for children is a significant problem worldwide. The psychological effects of this development are usually underestimated, while the myth of “psychogenic infertility” stubbornly persists. This article first provides an overview of the basic facts on the subject before highlighting the psychological effects of both the diagnos...

Purpose Endometriosis and infertility are associated with impaired partnership and sexuality of the patients, but also of their male partners. Also, endometriosis is one of the most common causes of infertility, resulting in a large overlap of both pathologies. The aim of this study was to determine the association of different predictors of partne...

Zusammenfassung Die Tatsache, dass Endometriose eine der häufigsten Unterleibserkrankungen bei Frauen und Mädchen ist, gerät immer mehr in den Blickpunkt der Öffentlichkeit und der Politik. Auch in der Praxis der niedergelassenen Frauenärztinnen und Frauenärzte in Deutschland bekommt diese Erkrankung einen größeren Stellenwert, es fehlt aber noch a...

Purpose This paper reports on the first evaluation of infertility counselling in Germany. Methods Sixty-nine infertility counsellors provided feedback via 524 survey sheets and 182 questionnaires were filled in by clients. Results The results show a high level of satisfaction on behalf of the clients. They valued the emotional support, informatio...

The apparent sensational successes of modern reproductive medicine (e.g. births after uterus transplant) seem to suggest that today the desire for a child can be made to come true almost at will. One of the detrimental aspects of this development is that the emotional impact both of involuntary childlessness and of medically assisted reproduction i...

The fact that endometriosis is one of the most frequent gynaecological disorders in women and girls is gradually attracting greater public and political attention. There is also substantial awareness of the disorder among German gynaecologists, albeit without sufficient “equipment” for discussing the condition with patients and providing psychologi...

This review provides a systematic overview of the state of knowledge to date of psychosocial risk factors with a focus on anxiety, depressiveness, and (lack of) social support among involuntarily childless women and men prior to assisted reproduction. The databases PubMed, PubPsych, PsycINFO-Ebsco, and Web of Science were searched for relevant publ...

Purpose Endometriosis and infertility are associated with impaired partnership and sexuality of the patients, but also of their male partners. The aim of this study was to determine the association of different predictors of partnership and sexual satisfaction in couples with endometriosis and infertility, as well as dyadic effects. Methods A cros...

Purpose For many couples, bearing children is a common life goal; however it cannot always be fulfilled. Undergoing infertility treatment does not always guarantee pregnancies and live births. Couples experience miscarriages and even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet...

Introduction For some patients, undergoing medical treatment for infertility is a cause of major emotional stress which the couple needs to deal with together; it can be said that infertility is a shared stressor. From the literature it is known that a subjectively perceived sense of self-efficacy supports the patient’s ability to cope adaptively w...

Background Approximately seven to nine percent of couples of reproductive age do not get pregnant despite regular and unprotected sexual intercourse. Various psychosocial interventions for women and men with fertility disorders are repeatedly found in the literature. The effects of these interventions on outcomes such as anxiety and depression, as...

Introduction Recurrent pregnancy loss is usually associated with significant psychological distress for both partners of the couple. It may act as a traumatic experience resulting in a posttraumatic stress disorder. The object of this study is to examine the posttraumatic impact of recurrent pregnancy loss on men and women and their interdependenci...

Purpose The aim of this guideline is to standardize the diagnosis and therapy of recurrent miscarriage (RM) using evidence from the recent literature. This is done by using consistent definitions, objective evaluations and standardized treatment protocols. Methods When this guideline was compiled, special consideration was given to previous recomme...

BACKGROUND Sexuality has a key impact on quality of life and on reproductive health. Infertility often results in sexual dysfunction. Despite this close association, addressing sexuality is not a standard component of infertility counselling, especially since in most countries sexual medicine is not a core element of specialist training. Even today...

STUDY QUESTION When couples have to face recurrent pregnancy loss (RPL), what are the partners’ wishes and needs and what is their perception of helpful and unhelpful factors with regard to their own, their partners’ and their families’ and friends’ ways of dealing with the problem? SUMMARY ANSWER Women and men with repeated miscarriages want open...

Background Endometriosis is often associated with severe dysmenorrhea, pelvic pain and dyspareunia and has a high impact on daily life as well as sexuality. Quality of partnership positively influences the course of various diseases and ability to cope with emotional and physical distress. However, studies focusing on the male partners of endometri...

This review presents the current state of research on the relationship between psychological stress and the onset and course of pregnancy. The influence of (everyday) stress on the onset of pregnancy appears to be negligible, whereas there are convincing indications for the possible impairment of the course of pregnancy by traumatic psychological s...

In der Erklärung »Sexuelle Rechte« aus dem Jahr 2008 der »International Planned Parenthood Federation« (IPPF 2008 [2009 auf Deutsch erschienen]) wird an zwei Stellen explizit auf die Reproduktionsmedizin verwiesen: »Alle Menschen sollen das Recht und die Möglichkeit haben, Technologien, Dienste oder medizinische Interventionen der Reproduktionsmedi...

Infertility is perceived by many of those affected by it as one of the most stressful episodes in life. Assisted reproduction can help only some of the people with a desire for children to experience the birth of a biological child. Most people who remain involuntarily childless eventually come to terms with the situation; their psychological well-...

Study question What are the psychological impacts of recurrent pregnancy loss (RPL) on men and women and their interdependencies? Summary answer Women show higher psychological risks than men, except for lack of social support. Avoidance behaviour of men correlates with higher posttraumatic stress of their partner. What is known already About 1–3...

Study question What are the psychological impacts of recurrent pregnancy loss (RPL) on men and women and their interdependencies? Summary answer Women show higher psychological risks than men, except for lack of social support. Avoidance behaviour of men correlates with higher posttraumatic stress of their partner. What is known already About 1-3...

Aim The purpose of this official guideline published and coordinated by the German Society for Psychosomatic Gynecology and Obstetrics [Deutsche Gesellschaft für Psychosomatische Frauenheilkunde und Geburtshilfe (DGPFG)] is to provide a consensus-based overview of psychosomatically oriented diagnostic procedures and treatments for fertility disorde...

Objective: To compare the psychological impact of recurrent pregnancy loss (RPL) on affected men and women and to determine risk and protective factors in both partners. Design: Cross-sectional study. Setting: University-affiliated fertility center. Patient(s): Ninety female/male couples and 14 women. Intervention(s): Participants complete...

Quality-of-life measurement is a basic prerequisite for psychologically sensitive fertility care and the FertiQoL is a psychometrically sound outcome measure in this field. The aim of the present research was to investigate the reliability and validity of the Hungarian Core FertiQoL. Two independent samples of infertile women were merged (n ¼ 320)....

This review highlights the significance of so-called psychogenic infertility from the perspective of current and evidence-based science. Although this concept still enjoys almost undiminished popularity both in guidebooks for couples with an unfulfilled desire for children and among many psychosocial and medical professionals, from a scientific per...

Zusammenfassung Hintergrund Das Fach „Medizinische Psychologie/Soziologie“ steht durch die aktuell anstehenden Studienreformen im Rahmen des „Masterplans Medizinstudium 2020“ verschiedenen inhaltlichen Änderungen gegenüber. Diese beinhalten u. a. eine Weiterentwicklung des Gegenstandskatalogs (GK) und des Nationalen Kompetenzbasierten Lernzielkatal...

Over the last few decades in Europe, both the number of unintentionally childless couples and the frequency of treatment with assisted reproduction techniques (ART) have been constantly increasing. With a view to assessing the psychosocial aspects of infertility and infertility therapy, section “Infertility and Assisted Reproduction – Basic Facts a...

Introduction Assisted reproductive technologies are typically perceived by couples as being an emotional burden. The objective of the study “Positive Ausrichtung bei unerfülltem Kinderwunsch” [Positive adjustment in infertility] (PACI) is to examine the efficacy and acceptance of a smartphone-supported psychosocial intervention during infertility t...

Bei dem Thema unerfüllter Kinderwunsch und v. a. während reproduktionsmedizinischer Behandlungen sollte heute eine psychosomatische Betreuung durch die behandelnden Ärzte wie die Einbeziehung externer psychosozialer Beratung selbstverständlich sein. Die gynäkologisch betreuenden Ärzte sollten Frauen im reproduktiven Alter frühzeitig hinsichtlich de...

Introduction Supporting and counselling couples with fertility issues prior to starting ART is a multidisciplinary diagnostic and therapeutic challenge. The first German-language interdisciplinary S2k guideline on “Diagnosis and Therapy Before Assisted Reproductive Treatments (ART)” was published in February 2019. The guideline was developed in the...

Introduction Infertility generally counts as a profound crisis in the lives of couples and as an emotionally stressful experience. For couples undergoing fertility treatment, this is especially true of the waiting period following embryo transfer, which couples say is the most stressful period during treatment. However, at this specific phase, psyc...

Nachdem der Arzt alle Informationen erhoben hat, um eine Diagnose zu stellen, präsentiert er in einem Beratungsgespräch dem Patienten die Behandlungsoptionen, im optimalen Falle so, dass der Patient als gleichberechtigter Partner bei der Entscheidung über die Behandlung mitwirkt. Chronisch Kranke erwerben in Patientenschulungen Wissen und Fertigkei...

Background FertiQoL is a questionnaire internationally developed to measure fertility-specific quality of life. It has been validated with infertile populations in many countries and used in several studies focusing on the psychosocial consequences of infertility in Europe, Asia, and North America. Methods Over a period of two years, 596 infertile...

Ärztliche Beratung bei Sterilität/und Reproduktionsmedizin findet in Deutschland auf Grundlage der „Psychosomatischen Grundversorgung“ statt. Die Inhalte sind geregelt in der „(Muster‑)Richtlinie der Bundesärztekammer 2006“, die sowohl die medizinischen als auch die psychosozialen Aspekte der ärztlichen Beratung festlegt. Diese Richtlinie wird nun...

Aim The aim of this official guideline published by the German Society of Gynecology and Obstetrics (DGGG) and coordinated with the German Society of Urology (DGU) and the German Society of Reproductive Medicine (DGRM) is to provide consensus-based recommendations, obtained by evaluating the relevant literature, on counseling and fertility preserva...

Purpose Official guideline of the German Society of Gynecology and Obstetrics (DGGG), the Austrian Society of Gynecology and Obstetrics (ÖGGG) and the Swiss Society of Gynecology and Obstetrics (SGGG). The aim of this guideline was to standardize the diagnosis and treatment of couples with recurrent miscarriage (RM). Recommendations were based on t...

Der prozentual größte Anteil befruchteter menschlicher Eizellen führt nicht zu der Lebendgeburt eines Kindes, oft endet eine Schwangerschaft als Frühabort. Vor allem bei bestehendem Kinderwunsch wird die Fehlgeburt von der Frau (und ihrem Partner) als gravierender Verlust wahrgenommen. Eine besondere Bedeutung hat der Frühabort nach assistierter Re...

Fehl-, Tot- und Frühgeburten gehen meist mit verschiedenen emotionalen Reaktionen einher, z.B. mit Trauer, Schock, Hilfslosigkeit und Selbstvorwürfen. Komplikationen des Trauerprozesses zeigen sich in depressiven Verarbeitungsmustern, posttraumatischen Belastungsreaktionen und komplizierter Trauer. Die Bewältigung des Verlustes wird durch dysfunkti...

STUDY QUESTION Goal of this qualitative study was the analysis of multiple reasons of men and women for using or refusing ‘social oocyte freezing’. SUMMARY ANSWER Participants reported a wide spectrum of attitudes toward ‘social oocyte freezing’, with distinct misjudgment regarding fertility decline and men being much more critical than women. WHAT...

Introduction The tendency to delay parenthood is increasing. It is partly driven by the availability of early reproductive technologies such as social oocyte freezing, the cryopreservation of oocytes for non-medical purposes. The goal of this study was to investigate relationships between attitudes towards social oocyte freezing and different socio...

Background The unfulfilled desire to have a child is often associated with (temporary) sexual dysfunction. Objective In this review the interrelationship of infertility and sexual disorders is described. The relevant sexual disorders and additional influencing factors are discussed in detail. Furthermore, suggestions for solution strategies and pr...

Der Trend zu späten Elternschaft wird durch die Möglichkeit von (frühzeitigen) reproduktionsmedizinische Techniken zur Planung einer Elternschaft in der Zukunft weiter angetrieben. Social Freezing bezieht sich dabei auf die Entnahme und Einfrierung von Eizellen aus nicht-medizinischen Gründen zur möglichen künstlichen Befruchtung zu einem späteren...

Recurrent miscarriages are associated with strong distress in patients. In this paper, we describe – based on the S1 guideline of the German Society for Gynecology and Obstetrics (DGGG) – the evidence-based diagnostic and therapeutic options in patients with recurrent miscarriages.

The experience of infertility and its medical treatment is for most couples an emotional challenging life crisis. For a successful coping with this crisis, it is essential to use only effective coping strategies. These are mainly active-confronting and meaning-based coping strategies, whereas avoidance coping strategies usually increase the persona...

ABSTR ACT Background Infertility patients often have high stress levels which, in some cases, represent a risk of developing depression or anxiety. The SCREENIVF questionnaire is a validated tool to evaluate such risks. Some coping strategies have been shown to be correlated with infertile couplesʼ levels of stress. Determining which strategies are...

Objective: Various psychosocial interventions have been recommended for infertile women and men, but it remains unclear what their effects on quality of live and on pregnancy rates are. Methods: An overview is given over recent reviews and meta-analyses to the effectiveness of psychosocial interventions in fertility disorders. Results: Five reviews...

Objective: Various psychosocial interventions have been recommended for infertile women and men, but it remains unclear what their effects on quality of live and on pregnancy rates are. Methods: An overview is given over recent reviews and meta-analyses to the effectiveness of psychosocial interventions in fertility disorders. Results: Five reviews...

Obwohl Paare mit unerfülltem Kinderwunsch aus psychologischer Sicht weitgehend unauffällig erscheinen, bedarf ein Teil der Paare einer psychosozialen Betreuung. In den letzten Jahren sind in Folge von psychosomatischer Forschung zu Fertilitätsstörungen in Deutschland detaillierte Beratungskonzepte entwickelt worden. Diese Beratungskonzepte sowie Le...

Der Trend zu späten Elternschaft wird durch die Möglichkeit von (frühzeitigen) reproduktionsmedizinische Techniken zur Planung einer Elternschaft in der Zukunft weiter angetrieben. Social Freezing bezieht sich dabei auf die Entnahme und Einfrierung von Eizellen aus nicht-medizinischen Gründen zur möglichen künstlichen Befruchtung zu einem späteren...

STUDY QUESTION Goal of this study was to investigate the relationship between fertility knowledge and attitudes towards ‘social egg freezing’ as an impact of different socio-cultural backgrounds (‘milieus’) in Germany. SUMMARY ANSWER There are distinct differences between attitudes toward ‘social egg freezing’ and socio-cultural backgrounds, age co...

Aim: Involuntary childlessness is seen as major life crisis for men, with distress, anxiety and feelings of depression rising over time in fertility treatment and treatment procedures are sensed as high burden. Main goal of this study was to explore the experience and perception of men in diagnostic and sustained process of fertility treatment and...

Einleitung: Ungewollte Kinderlosigkeit gilt als kritisches Lebensereignis und geht häufig mit Gefühlen von Sorge, Angst und Depression einher. Besonders die reproduktionsmedizinische Behandlung wird als hohe Belastung aufgefasst. Ziel der Studie war die Exploration der männlichen Wahrnehmung von Fruchtbarkeitsbehandlungen sowie die Identifikation d...

The goal of this study was to explore the experience and perception of men during the diagnosis of infertility and subsequent treatment, and the impact on role concepts, control beliefs, and quality of life on these processes. Furthermore, it aimed to derive improvements in how men should be counselled. A qualitative study was conducted. It consist...

Einleitung: Die fertilitatsbezogene Lebensqualitat ist bei ungewollt kinderlosen Frauen und Mannern beeintrachtigt. Die Veranderungen in den emotionalen, psychosomatischen, paar- und sozialbezogenen Bereichen der Lebensqualitat konnen mit unterschiedlichen soziodemographischen Merkmalen zusammenhangen. Methoden: 362 Frauen in Kinderwunschzentren in...

Einleitung: Der Trend zu späten Elternschaft wird durch die Möglichkeit von (frühzeitigen) reproduktionsmedizinische Techniken zur Planung einer Elternschaft in der Zukunft weiter angetrieben. Social Freezing bezieht sich dabei auf die Entnahme und Einfrierung von Eizellen aus nicht-medizinischen Gründen zur möglichen künstlichen Befruchtung zu ein...

Background Only a few studies have reported cross-cultural comparisons regarding psychosocial consequences of infertility. Differences between societies with different cultural backgrounds were revealed and seemed to be based on the importance of pronatalism. Our aim was to measure cross-cultural differences in fertility specific quality of life of...

Goal of this study was to investigate differences in quality of life in men contingent upon various fertility treatment stages, infertility causes and adoption of roles. A quantitative study with n = 115 men in three German fertility centres was devised. Participants completed a standardised, fertility-specific questionnaire devised for men (TLMK),...

Nachdem der Arzt alle nötigen Informationen erhoben hat, um eine Diagnose zu stellen, geht es darum, dem Patienten die Behandlungsoptionen zu präsentieren. Dies geschieht in einem Beratungsgespräch. Wenn der Arzt das Gespräch optimal gestaltet, kann der Patient die medizinische Ausgangslage nachvollziehen und als gleichberechtigter Partner bei der...

Purpose: Official guideline coordinated and published by the German Society of Gynecology and Obstetrics (DGGG). Aim of the guideline was to standardize the diagnosis and treatment of patients with recurrent miscarriage (RM). Recommendations were proposed, based on the current national and international literature and the experience of the involved...

Study question: Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? Summary answer: Using the structured methodology of the Manual for the European Society of Human Reproduction and Embryology (ESHRE) Guideline Develo...

Study question: Main goal of this study was to investigate differences in quality of life in men contingent upon various fertility treatment stages, infertility causes and adoption of roles. Summary answer: Participant’s perceptions on quality of life differed in enormity according to the cause of infertility, treatment stage and number of adopted...

Purpose: Official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). Aim of the guideline was to standardize the diagnosis and treatment of recurrent miscarriage (RM). Recommendations were proposed, based on the current national and international literature and the experience of the involved physicians, a...

Response to Frederiksen et al. (2015) BMJ Open 2015;5:1 e006592 doi:10.1136/bmjopen-2014-006592 http://bmjopen.bmj.com/content/5/1/e006592.abstract/reply#bmjopen_el_9103

Aim: This paper describes the theory-based development of a standardized training model for peer tutors. The aim is to qualify tutors to teach communication skills integrated with practical clinical skills, to medical students in the pre-clinical curriculum. As a result, students are encouraged to form a basic understanding of the biopsychosocial...

Bei der Präimplantationsdiagnostik (PID) handelt sich um eine spezifische Diagnostik im Rahmen der Reproduktionsmedizin. Sie bleibt seit 2011 unter bestimmten Vorgaben in Deutschland straffrei, darf allerdings nur zum Zweck der Verhinderung schwerwiegender Erbkrankheiten bzw. zur Verhinderung von Fehl- bzw. Totgeburten aufgrund schwerwiegender Schä...

In this review the most recent studies on the experience of the male partner in infertility treatment and their findings will be presented. The psychosocial impact of involuntary childlessness on men has not been taken into consideration appropriately yet. This applies to the research on this issue as well as to the infertility treatment. As conclu...

PGD (preimplantation genetic diagnosis) is a specific diagnostic procedure within ART (assisted reproductive treatment). In Germany, since 2011, PGD is allowed if it is carried out in order to avoid a severe hereditary disease, a miscarriage or stillbirth resulting from a severe disability of the embryo (social sexing, as legal in countries such as...

Die psychosoziale Kinderwunschberatung ist eine spezialisierte Form der psychosozialen Beratung, die nicht nur Beratungskompetenz, sondern auch Fachwissen im Bereich der psychologischen, sozialen, medizinischen, ethischen und juristischen Aspekte der Reproduktionsmedizin erfordert. Die Deutsche Gesellschaft für Kinderwunschberatung - Beratungsnetz...

Hintergrund Der unerfüllte Kinderwunsch stellt häufig eine erhebliche emotionale Belastung dar, die eine professionelle Unterstützung erforderlich machen kann. Methoden In dieser Übersicht wird dargestellt, welche psychologischen bzw. psychotherapeutischen Verfahren vor dem Hintergrund einer evidenzbasierten Betrachtung in der Reproduktionsmediz...

Introduction: As gender role attitudes and the evaluation of parenthood and childlessness have subtle variations in each society, cross-country studies focusing on infertility are needed to draw a complex picture in the psychosocial context of infertility. This study investigates similarities and differences between German and Hungarian in-fertile...

Introduction: Infertile couples often report quality-of-life impairments, especially in terms of sexuality, self-esteem and partnership quality. So far, there have been no systematic studies of the sex lives and behaviour of infertile women and men before and after the emergence of their mutual desire for a child. Materials and Methods: From Februa...