MAP: what are the psychological effects on the couple?

Publié le 30 Sep, 2010
In the occasion of the revision of the law of bioethics, Le Quotidien du Médecin opened its newspaper to Dr Sylvie Epelboin, gynaecologist co-responsible of the centre of medical assistance to procreation (MAP) of the hospital Bichat-Claude-Bernard of Paris, so that she explains the psychological repercussions of the MAP on the couples.
Control of privacy
The medical assistance to procreation (MAP) represents a very delicate field where the introduction of a medical third in the life of the couple may generate a really strong feeling of intrusion and of “medical control of privacy“. Indeed, from the beginning of the path, the examinations required for establishing a balance of fertility oblige the members of a couple to unveil intimate facts, against a certain natural decency. Sometimes, these consultations reveal tensions, disagreements or injuries which belonged to the unsaid field. Finally, the imposition of scheduled reports, under medical monitoring, has consequences on couple sexuality which loses spontaneity.
Negative self-image and guilty feeling
Moreover, the fact to mention the different causes of reduction of fertility in medical terms (uterine malformation, oocyte age, inadequate cervical mucus, etc.) can hurt and generate in woman and its spouse a feeling of abnormality and guilty, as well as regrets concerning choices of previous life.
In women, when no cause of infertility is detected, except an advanced age, the part of responsibility in the failure of attempted pregnancies is experienced with difficulty. This is also the case for women who have delayed “a child project for professional reasons” or who have “experienced in the past a termination of pregnancy“.
For men, the description of spermatozoid abnormalities can “return a negative image of his virility and be experienced like a form of impotence.” He may also feel responsible for heavy and restricting procedures that must experience his spouse. Finally and generally, he has difficulties to find his place in a gynaecologic context.

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