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Aspectos emocionales en la infertilidad: una revisión de la literatura reciente
Abstract
Infertility is defined as a couple's inability to achieve pregnancy after one year of unprotected intercourse. This problem affects 15% of couples of fertile age in Chile. The impact of infertility on the couple is assessed, and it is described as an emotionally debilitating life crisis due to multiple factors. It is characterized by a cyclical pattern in which the experience of hope (at the beginning of the cycle) is recurrently followed by the experience of failure (when menses begin). The high financial burden of treatment, the need to undergo surgical procedures, and the invasion of sexual intimacy are additional sources of stress. Infertile couples may suffer feelings of inadequacy, despair, sorrow, envy and jealousy towards pregnant women, fear, loss of sexual desire, erectile dysfunction, emotional instability, loss of self-esteem, guilt, depression, and suicidal ideation. Psychosomatic disorders, the repression of emotional reactions, and frantic desires to quickly adopt a child or to join a program of assisted reproduction are described. Following therapeutic failure, which is the most common outcome (70%), fifty percent of couples show some significant psychological distress. The authors review recent literature on the subject and underscore the need for mental health professionals to collaborate with infertility specialists in these cases
... Ejemplo de un estudio netnográfico: La adopción de niños como fenómeno en las redes sociales La adopción surge desde políticas nacionales e internacionales para cumplir los derechos que tienen los niños, niñas y adolescente (NNA) en cada nación surgiendo así desde los derechos humanos de estos, así también como un derecho de las personas que quieren adoptar, cumpliendo los requisitos legales que le solicitan, como lo son las cualidades emocionales, cualidades psicológicas y económicas (Palacios y Jadresic, 2000). ...
Introducción En el mundo digital viajan por segundo contenidos o temas relacionados al hombre, por consecuente información confiable y no confiable. Este ensayo se busca un acercamiento de cómo abordar el tema de adopción en el ciberespacio a través del método netnográfico. En la parte introductoria se busca aterrizar la epistemología, ontología y axiología en la teoría de la adopción de niños, en la segunda fase se adapta y se ejecuta el enfoque netnográfico sobre la adopción. La tercera fase es la recolección de datos sobre la adopción en cuatro redes sociales en Internet. Por último se realiza el análisis de la información recabada de las cuatro redes sociales sobre la adopción. Un tema que necesita verse con lupa para situar su teología. En el mundo cambiante del hombre, en la era digital de la que se encuentra, el individuo ha querido evolucionar en el pensamiento y estar en grupo por su necesidad de pertenecer a algo. Como factor humano como ser social, necesita de aceptación de otros. La netnografía la describen como la indagación social, discurso científico, cibercultura, revisión, interacción digital, cosmologías y e innovaciones emergentes en los medios digitales en la que se hace nueva investigación, nuevas formas de investigar, con diferentes universos, a nuevas formas de construir conocimientos. Por ende el hombre ha querido estar a la vanguardia y en sociedad digital, unidades sociales, etnometodología, comportamiento en redes, grupos de
... O casal atravessou diversos desafios para realizar o desejo da parentalidade. Depararam-se, inicialmente, com a infertilidade cujo diagnóstico pode provocar uma interrupção no projeto de vida do casal, problemas nos relacionamentos sociais e familiares, além de sentimentos como tristeza, impotência e culpa (Domínguez, 2002;Palacios & Jadresic, 2000). A transformação na vida do casal e os sentimentos provenientes desse diagnóstico podem aumentar a chance de insucesso da concepção (Faria, Grieco, & Barros, 2012 Psicol. ...
Este estudo objetivou compreender a experiência da parentalidade de um casal heterossexual querecorreu à ovodoação e que tevetrigêmeos. O casal respondeu, individualmente, as entrevistas sobrematernidade e paternidade em três períodos: gestação, três meses e primeiro ano de vida dos bebês.Após repetidas leituras das entrevistas, construiu-se o relato clínico. Os resultados revelaramquestionamentos da mãe sobre a própria maternidade e uma compensação exacerbada nos cuidadoscom os bebês para suprir a ligação não consanguínea com os filhos. Além disso, as dúvidas arespeito da revelação da origem dos trigêmeos demonstraram angústia e desamparo frente aocontexto da ovodoação.
... Los sentimientos de desesperanza, tristeza, ansiedad y confusión se relacionan con la infertilidad. Algunos estudios revelan que las alteraciones emocionales pueden ser: "sentimientos de inadecuación, desesperación, pena, envidia y celos hacia la mujer embarazada, miedo, pérdida de la libido, impotencia, inestabilidad emocional, pérdida de la autoestima, culpa, depresión e ideación suicida" (Palacios y Jadresic, 2000). ...
El libro recoge una colección de artículos producto de investigaciones adelantadas por docentes del Departamento de Humanidades y cuyo centro temático
es la relación entre las personas y la felicidad. Cada capítulo brinda respuestas
desde un ámbito específico disciplinar, a través de una metodología cualitativa,
al problema antropológico y ético de la consecución de la felicidad o la realización humana personal. Desde la educación y la ética se plantea la transición de
unas humanidades informativas a otras performativas, que integren formación
moral y valores sobrenaturales, que aboguen por la empatía y la solidaridad como
camino humano de felicidad. A partir de las claves antropológicas de Leonardo
Polo se presenta a la persona como ser capaz de dotar de sentido su modo de
estar en el mundo, más allá de la propia satisfacción felicitaria, pues ella misma
es un sentido personal capaz de manifestarse en la tarea esperanzada. Así mismo, desde la antropología personalista se estudia la felicidad como proyecto de
vida, pasando de la conflictividad hacia la espiritualidad y proponiendo decantadas transformaciones político-educativas. En el ámbito de las ciencias históricas se analiza el uso de los conceptos de persona y felicidad en el Magisterio
de Juan xxiii subrayando las perspectivas sugeridas por el Papa y recogidas por
los pontífices sucesivos. Desde el derecho se analiza la relación entre justicia y
felicidad, aplicada al llamado “derecho a morir dignamente”; y desde la bioética
se plantean reflexiones sobre procreación y felicidad a partir del debate actual
sobre la maternidad subrogada.
Palabras clave: justicia y felicidad, realización personal, derecho a morir dignamente, maternidad subrogada, magisterio pontificio, antropología trascendental,
ética y educación.
... Palaces et al 58 indicate that men that confront the death of their child will go through the following phases: (1) paralysis, (2) longing, (3) disorganization, and (4) reorganization. The first phase refers to when a man feels distant from others. ...
The current article contains compilation of significant contributions done by theorists over the years about the phenomenon of perinatal loss. The objective of this paper is to provide information about important emotional and psychological consequences on parents who suffer stillbirth. This article addresses identity issues of the mother, father, and their relationship as a couple. It also provides information on the psychological, emotional, and legal aftermath of healthcare professionals who assist during the process of loss.
... en esta misma línea, autores como palacios y Jadresic [25], quienes han estudiado el proceso de duelo en los seres humanos, señalan que los varones ante la muerte de su futuro hijo, viven en primer lugar una fase de paralización, en donde puede haber manifestaciones físicas y emocionales, se puede presentar un distanciamiento de las personas que le rodean, luego sobreviene el anhelo, cuyo elemento central es la necesidad de concretar el deseo de ser padre. La desorganización y desesperación se presentan por un periodo más largo de tiempo, en el que por lo general experimentan ansiedad, desesperanza y falta de control. ...
A lo largo de la historia se ha visto que el concepto de paternidad se
ha ido modificando debido a los cambios que han sufrido las distintas
sociedades, por lo que los modelos de comportamiento de los varones
en cuanto al embarazo, parto y crianza han evolucionado hacia
formas de paternidad más afectivas y no sólo a la de proveedor material.
Lo anterior ha traído como consecuencia que la pérdida de un hijo
en la etapa perinatal, repercuta en aspectos psicológicos y psicosociales
que impactan en la calidad de vida de los varones. el propósito de
este trabajo es exponer de manera breve información sobre este
tema, así como la experiencia clínica que se ha tenido en el manejo
psicológico de la paternidad y la pérdida perinatal en varones.
El objetivo de este estudio fue describir los principales aspectos emocionales asociados a la infertilidad y su tratamiento. Con este fin, se evaluaron 106 pacientes infértiles, 72 mujeres y 34 varones, en tratamiento en Unidades de Medicina Reproductiva de la ciudad de Santiago. Se encontraron diferencias en la reacción psicológica de mujeres y hombres. Mientras en las primeras predominó la inestabilidad del ánimo (75%), pena (68,1%) y rabia (50%), entre los varones fueron más frecuentes la ansiedad (46,7%), la pena (36,7%) y la inestabilidad del ánimo (33,3%). En lo laboral, las mujeres expresaron dificultades para asistir a los controles y la percepción de menoscabo en el rendimiento. Los varones a menudo manifestaron tener que trabajar más para asumir los gastos. En ambos sexos se observó una asociación entre acumulación de vivencias negativas y mayores grados de compromiso en los ámbitos social y laboral. También ambos sexos coincidieron en opinar que la infertilidad afecta más la vida sexual (33,7%) que la relación de pareja (15,4%).
El balance no ha concluido, pero en su transcurrir resulta insoslayable que, entre construcciones, deconstrucciones y reconstrucciones en devenir, nuevos paradigmas y modalidades relacionales tallan la manera de capturar, comprender y explicar la realidad. Estas transformaciones, ponen en crisis preceptos instituidos en los campos disciplinares y por ende las creaciones transdisciplinares.
The advance in Human Reproductive Technologies introduces new scenarios in our practice, which require our examination. The ethical dilemmas that arise turn out to be a particularly challenging field, because they confront us with the complexity that the tension of the articulation between Law, Bioethics and Psychology presents, allowing the question about symbolic filiation. We consider that films constitute a potentially rich means to address the singularity of these situations, and in this article we suggest different themes for film-analysis intended for therapeutic work: analytical cinematherapy. The attempt is to promote a place for reflection in which the focus
The main objective of this research is to investigate the adaptive efficiency of women who experienced induced and spontaneous abortion and attended a Human Reproduction Ambulatory. The instrument used in this study is the clinical preventive interview - EDAO. Ten (10) women who were currently attending the Assisted Human Reproduction Ambulatory participated in the study. The results showed that the abortion has important repercussion in both internal and external world of the participating women. Both induced and spontaneous abortions were related to intense anguish, sadness and guilt. The experience with the pregnancy attempt treatment added to the prior miscarriage experience have intensified the suffering of these women. As for the adaptive efficacy, two patients were diagnosed with Mild Inefficient Adaptation operationalized with a good prognosis and four diagnosed with Moderate Inefficient Adaptation prognosis regular and four showed Severe Inefficient Adaptation and the prognosis was guarded. It is recommended, in all cases, referral for psychological evaluation. It is recommended, in all cases, referral for psychological evaluation.
According to our basic (psychosomatic) tenet, every somatic problem has its emotional side; therefore, medical treatment and
counselling are not separate but are interlinked and equally important. First interviews and interviews after failed assisted
reproductive technology (ART) are held together in four person settings; the couple with two counsellors. The sessions last
for approximately 1 h. The aim is to help patients escape the agonizing and distressing state in which they are kept by their
foci (psychogenic aspects causing distress). Stress and iatrogenic factors are discussed and when patients are able to re-experience
their suffering, many possible psychological effects on infertility and/or treatment failure are explored. If the patients
consciously perceive these mechanisms of action, they will turn to their basic emotional needs and perspectives; approximately
30% of them will conceive later while approximately 20% opt for adoption. However, half of the patients take no positive action,
neither giving up nor continuing with activities for a child. Nor do they seek counselling. The analysis of many of their
reports argues in favour of an adaptive model for coping with reproductive failure.
The objective of this study was to assess patient satisfaction with the investigation and initial management of infertility. A postal questionnaire survey was carried out of 1366 women attending outpatient clinics for the investigation and initial management of infertility at 12 hospitals throughout Scotland. The response rate to the questionnaire was 59% (806/1366). Overall, 87% of responders were satisfied or very satisfied with their care but a number of deficiencies were identified. Thirty-nine per cent had never been asked to bring their partner to the clinic and 86% felt they had not been given enough help with the emotional aspects of infertility. Forty-seven per cent felt they were not given a clear plan for the future and 23% of those who had been given drug treatments reported receiving little or no information about the treatment or possible side-effects. Overall, only a third had been given any written information and 78% expressed a wish for more written information. Women ranked 'the information and explanation given' and the 'attitude of the doctor at the clinic' highly in comparison to other aspects of their care, including 'help with the emotional aspects of infertility'. In general women were satisfied with their care but improvements may be made by giving more explanation and written information and by adopting a more couple-centred approach. Where resources allow, clinics should take steps to address the emotional aspects of infertility.
A questionnaire was sent to 2000 members of two of the largest national infertility support organizations as part of the National Infertility Awareness Campaign (NIAC), 1997. A total of 980 questionnaires was completed and returned to the market research company, Ballington Hall. Some 69% of the respondents were aged between 30 and 39 years. One-third of the couples had been trying for a baby for more than 3 years, including one-tenth who had been trying to conceive for more than 10 years. Some 40% of respondents were successful in conceiving, although a significant proportion of these took more than 6 years. About 75% of those surveyed had been forced to pay for some or all of their infertility treatments and investigations, whereas 18% had their treatments funded fully by the National Health Service (NHS). Funding sources for the remaining 7% were unknown. Just over one-third of respondents felt that their GP provided sufficient information about the causes of infertility investigations and treatment, while the majority said that their specialists had been helpful. One in three said that they did not fully understand the medical nature of their own or their partner's infertility. A wide range of negative emotions was experienced by respondents. One in five said they experienced suicidal feelings; one in three said that infertility had strained their relationship; and just over one-quarter found that their relationship improved as a result of the treatment. Some 71% said that they would request counselling if it were offered free, but only 12% had been provided with free counselling on the NHS.
A link is suggested to exist between any unexplained or relatively unexplained lowering of fertility and an inner sensitivity,
largely or wholly unconscious, to some situation that renders it an unsuitable time or place for the individual or couple
to allow the arrival of a baby. The psycho-social and intra-psychic processes involved in such situations can be quite subtle,
and the question of their neuroendocrinological connections presents an intriguing area for future research. Some sociological,
anthropological and psycho-analytical findings relevant for this theme are outlined here. Three illustrative vignettes are
presented, the clinical material on which the findings are based is summarized briefly, and a discussion is held about what
appears to be required in treatment.
Research to date has not been able to dispel controversy over the question of "psychogenicity" of infertility. Increasing numbers of studies suggest that neuroendocrinological factors play a role in what is most likely a multidetermined condition. Whatever the etiology, and whether infertility occurs spontaneously (e.g., anovulation) or by choice (e.g., surgical sterilization), the physician must be alert to the special needs of the patient, to the environmental setting, and to the intricate interplay between infertility and emotional reaction. The physician-patient relationship as a triadic rather than dyadic relationship introduces unique transference and counter-transference considerations which must be an acknowledged part of evaluation and treatment.
The causes of infertility can be divided into seven categories. In older couples, valuable time can be lost if evaluation is delayed. An orderly diagnostic approach assures that no diagnosis is overlooked. Many of the causes of infertility are amenable to therapy.
Counselling in reproductive medicine has tended to focus on bereavement theory as the primary model of understanding and practice. This has meant that the experience of infertility has principally been conceptualized as a process with definable stages, leading smoothly, in time, to resolution and acceptance. This paper suggests that, whilst this is a valuable theory of the psychological and emotional components of infertility, it is also important to consider depression as a particularly significant aspect, independent of its being seen as a stage in the mourning process. The paper outlines an understanding of depression and gives case illustrations of the significance of depression for some people with infertility problems. The evidence for the prevalence of depression amongst those with impaired fertility and the various areas of personal functioning which might be affected are considered. Cognitive therapy has come to be widely accepted as an important approach to treating depression. The theoretical and research evidence for the efficacy of cognitive therapy is discussed, and how it might be applied in the context of infertility counselling.
The emotional response to infertility, a major circumstantial loss, is frequently likened to bereavement. It is described as circumstantial because it does not happen to everyone, unlike a necessary loss, such as being weaned both nutritionally and emotionally. Another circumstantial loss is the death of someone, particularly if one has close emotional ties to this person. It is not surprising to find that a conceptual framework, developed to understand mourning a death, is used to make sense of the reaction to infertility; but this framework alone is not sufficient. The understanding of stigmatization and learned helplessness also assist helping the infertile to come to terms with their loss. It is suggested that the pronatalist tendency of British society results in denial of the stressful nature of infertility which compounds the difficulty in the loss being recognized and makes it exceptionally difficult to grieve.
In a survey involving 281 patients awaiting assisted reproduction treatment at five centres in three countries, and 289 population controls, we investigated whether the patients had experienced more negative emotional feelings and negative emotional impact during periods when they were attempting to conceive as compared with the controls, and whether there was any difference in their well-being at the time of consultation. The study was performed in the context of currently divergent views as to the burden of fertility problems. The survey was carried out using questionnaires of the self-administration type. Women with fertility problems did in fact consistently report a higher prevalence of negative emotions than the controls with reference to the periods during which they had been trying to conceive. Patients reported more changes in interpartner relationships (either negative or positive). Sexuality was negatively affected among the patients. At the time of consultation, the patients had less favourable scores than the controls on scales for depressed mood, memory/concentration, anxiety and fears, as well as for self-perceived attractiveness. One in four (24.9%) of the patients had scores indicating depressive disorders as compared with only 6.8% of the controls. Current well-being was even more markedly affected in patients with previous unsuccessful in-vitro fertilization (IVF) experience. The 'infertility' life event was perceived as severe by both patients and controls. Both prior to consultation and during diagnosis and treatment, women with fertility problems had a higher prevalence of reported negative psycho-emotional experiences than women without fertility problems.