Abstract:

Actually, this document comes from personal experience with IVF and the hundreds of couples struggling to have a child by artificial means in a Chinese hospital in Shanghai. At the same time, I was asked to give psychologists insight into IVF procedures from a telehealth company with a subscription channel for thousands of parents and potential parents. The content outline is not about the IVF (In Vitro Fertilization) procedure but about the stress of going through the process from wanting a baby to the actual birth. All the tribulations and disappointments on the way to the eventual success of a pregnancy leading to eventual birth or not! Also a case for psychological care of IVF patients.

Introduction:

IVF treatment along with other artificial ways to get pregnant are becoming more and more common for couples who cannot wait for nature to take its course through normal reproductive sexuality. Stressors come from many areas for the couple wanting to make this their chosen route to raising a family. In most Western countries, IVF is offered to childless couples and older couples who have been trying for some time to get pregnant normally. However, in many other countries it is a way to ensure the birth of a child (cultural assertion) by effectively sexing fertilized eggs by gender (although it is illegal in most countries). In China, young couples who feel pressured by their family to have a child (potential grandparents who are unwilling to wait), choose IVF as a quick method of pregnancy and fulfilling their traditional roles. The one-child policy to control overpopulation was relaxed in 2017 and a two-child policy is now in effect. Most couples who already have one child did not want a second, as the cost of raising a child in China is enormous. However, especially when the only child was a girl, the family pushed the wife to commit to the second child in order to have a boy. The birth of a second girl would be seen as a shame. It’s quite amazing to go to a maternity hospital in China and see the sheer number of young couples under 30 trying for a second child. Those who are trying for the first time are also trying to avoid divorce. Women who cannot produce for the family would certainly be shamed by the family and the mother-in-law on the children’s side would push for a divorce in order to find a more suitable girl for her son.

However, let’s see where it all begins: not getting pregnant normally through sexual contact. In many cases, the blame game begins with whose fault is it? Men often feel that it must be the wife’s fault, as they cannot face the shame of knowing that they are the ones with a problem, be it medical or psychological. So, initially, it is often the wife (or partner) who goes to the doctor and gets all the checkups, internals, blood tests, scrapes and more, all of which leave a woman feeling inadequate. However, if all is well and no medical or biological reason can be found for her not to be pregnant, then the next step, of course, is the male. For men who are given a small cup and a room with some suggestive pictures on the wall and asked to ejaculate sperm is not the easiest thing to do. However, with a little imagination and sometimes a little help from the wife, things progress and the cup has a spoonful of sperm and semen to take to the hospital laboratory. It’s actually disheartening to see the nurse throw away most of it (they only need a one minute sample), since she had time to produce it. A sense of humor is often the best protection against embarrassment. At this point, after the agonizing wait, the results come in the form of a printout he cannot understand and he is asked to take it to the doctor for analysis. The man silently waits for his sperm to be strong active swimmers so he can relax.

If all is well with both parties, then the procedure begins in earnest with most women going to many (and I mean many) appointments over a period of months to go through the complex process of preparing their body, womb, and eggs. for the inevitable fertilization by the males they collected sperm. (Often frozen and waiting for the right moment).

Road stress:

1. Blame: the initial who is to blame. The stress of the unknown cause of the lack of pregnancy: the need to follow complex monthly cycles that still do not seem to produce the desired results. Guilt can occur at many stages of IVF, mainly due to the inability of the female partner to give the family the desired result.

Fear: fear of not being able to produce the baby that everyone asks of you! Afraid that there is something wrong with you. Fear that it may end in divorce or separation. Like blame, fear is a constant throughout the IVF treatment. At any time, you may be asked to start over from the beginning, because something was not taken correctly or a missed moment was not taken.

2. Disappointment: despite several attempts, the pregnancy is not happening; the cost and economics of chasing a baby are no longer affordable. The risk of stopping – and trying again later – the cultural outcome of being a failed woman and a poor wife.

3. Failure: Like the moment before when the doctor tells you that will never happen and that you should think about alternatives like adoption or not having children. For many, this is the ultimate failure and can again lead to the blame game and the end of the marriage. This can also affect people’s self-esteem in the sense that I am not normal: I am a failure as a woman or a man. It can also mean that after a non-fertilization divorce, your chances of remarriage are slim to none.

4. Success: You’d think a successful implantation would be a dream come true, but you’re in the same position as any pregnant couple. What else can go wrong? Many IVF insertions can be aborted, rejected by the body, and having medical problems in the womb brings other decisions about birth or abortion.

5. The baby is finally born – now parenthood begins – the stress of being a new mother to an IVF child – the stigma of secrecy – pretending everything was normal. Family pressure to start over for the second child.

6. Multiple Births – The idea was for a baby to start a family and end up with twins and even triplets – the financial burden alone in some countries adds to the stress felt by everyone.

All of the above points are a common experience of IVF couples, and more so the younger the couples (under 30 years of age), as older couples tend to be more realistic about the possibilities and outcome from the start. Out of 100 couples (in a decent hospital) only 18 manage to carry out the procedure. Being that age makes a huge difference in your success. Between the ages of 22 and 34 an average of 30% have a live birth, from there the statistics drop rapidly from 38 to 42 around 20% after the age of 46 only 1% succeed. (1. US Division of Reproductive Health 2001)

Another aspect of IVF is the increase in multiple births for older couples: from 38 to 40 years each attempt increased the chances of multiple births for twins by 25% on average. (2. US Government Health Statistics 2001). It’s very difficult to get meaningful statistics in China anyway.

Summer:

The procedure is long: from 6 months for a successful first attempt to several years and many failed attempts to succeed. Give up at some point with all the cultural and social risks involved or move on and the inevitable financial burden of every attempt and failure.

Even a successful outcome can be stressful, like being the new parents of a baby or two or even three! Unfairly, it can also be due to good luck that everything seems to be going well, as in the case of the 62-year-old Irishman and his 31-year-old Chinese wife, who underwent a vasectomy at the age of 20 and had to extract the sperm from their testicles ( without anesthesia) and implanted 9 sperm into her eggs – 7 were taken and 2 implanted – and bingo, the wife is pregnant with twins – eight months later – a healthy twin boy and girl are born. (3. Myler 2017) This would be a dream outcome for many young couples who fail time and time again.

The role of counseling:

It is important to note that not once in all the hospitals or clinics that performed IVF did they offer any kind of counseling to couples who were going through the stress of the procedures. Clearly, however, there is a very strong need for such support: understanding the doctor’s procedures can help you understand what will happen to your body and the chances of outcome, but it cannot prepare you for the ups and downs of emotions you feel ahead. the blame. , failure, self-esteem problems and fear of the future: these problems need a support counselor or psychologist who listens and cares. It is a well-known fact that stress hormones and psychological stress can greatly affect the outcome of medical procedures in all sorts of areas. Psychology should not be seen as a luxury, but as an essential part of all IVF procedures.

References:

1. US Division of Reproductive Health 2001

2. US Government Health Statistics 2001

3. Myler SF (2017) Irish/Chinese twins – Clinical case