Emotional aspects of assisted reproductive medicine

Reproductive medicine seems to be a field in which emotions are not of immediate necessity or do not come to light. We are acting within a strict framework of diagnoses which all have a clear etiology and, hence, can be treated with a specific therapy. For example, hyperprolactinemia is treated with prolactin inhibitors, hyperandrogenemia is treated with prednisolone or dexamethasone and, for stimulation of the ovaries (superovulation), clomiphene citrate, human menopausal gonadotropin (hMG) and follicle stimulating hormone (FSH) are available. Tuba1 factor infertility can be treated with laparoscopic tubal surgery or microsurgical correction, or by means of in vitro fertilization (IVF). Nearly everything can be traced back to the quality of the oocytes and semen parameters. For severe male fertility disorders, we implement the intracytoplasmic sperm injection (ICSI) method. We obtain ‘good’ embryos with a regular appearance, or fragmented, ‘bad’ embryos with an irregular appearance. The result of this medicaltechnical view of sterility medicine is that the female patient is reduced to ovarian and tubal functions and oocyte quality, and the male partner is reduced to his semen. The doctor determines diagnostics and therapy and keeps them under observation. The nurselmedical assistant takes blood samples and gives injections, the laboratory technician determines the hormone levels or counts the sperm, and finally the biologist sees only the embryo as the product of the couple. Ifthe couple’s emotions come to light, the psychologist or counselor takes care of them. We generally deal with parameters that are quantifiable. Where could there be space for the emotions of all the people involved? This article discusses mainly the physician’s role, although what is said applies to psychologists, counselors, nurses and biologists as well.