Infertility impact: Difference between revisions

Jump to navigation Jump to search
(Created page with " __NOTOC__ {{Infertility}} Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing. {{CMG}} ==Impact=...")
 
 
(7 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Infertility}}
{{Infertility}}
Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.


{{CMG}}  
{{CMG}}  
==Impact==
==Impact==
===Overview===
Infertility has an impact on couples ethically, psychologically and socially.
===Ethical Impact===
===Ethical Impact===
There are several ethical issues associated with infertility and its treatment.
There are several ethical issues associated with infertility and its treatment.
*High-cost treatments are out of financial reach for some couples.
*High-cost treatments are out of financial reach for some couples.
*Debate over whether health insurance companies should be forced to cover infertility treatment.
* There is debate over whether health insurance companies should include cover for infertility treatment.
*Allocation of medical resources that could be used elsewhere
*There is some grey area around the legality and status of [[embryo]]s fertilized [[in vitro]] and not transferred [[in vivo]].<ref name="pmid17169194">{{cite journal| author=Koeferl Puorger UP, Buergin M, Wunder D, Crazzolara S, Birkhaeuser MH| title=Surplus embryos in Switzerland in 2003: legislation and availability of human embryos for research. | journal=Reprod Biomed Online | year= 2006 | volume= 13 | issue= 6 | pages= 772-7 | pmid=17169194 | doi=10.1016/s1472-6483(10)61023-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17169194  }} </ref>
*The legal status of [[embryo]]s fertilized [[in vitro]] and not transferred [[in vivo]].
* Anti-abortion lobby groups oppose the destruction of embryos not transferred [[in vivo]] as they  believe in the personhood status of embryos, regardless of transfer [[in vivo]] or not.  
*Anti-abortion opposition to the destruction of embryos not transferred [[in vivo]].
* IVF and other fertility treatments have resulted in an increase in [[multiple birth]]s, provoking ethical analysis because of the link between multiple pregnancies,[[premature birth]], and a host of health problems and financial strain due to the same on couples.
*IVF and other fertility treatments have resulted in an increase in [[multiple birth]]s, provoking ethical analysis because of the link between multiple pregnancies,[[premature birth]], and a host of health problems.
* Religious leaders' have differing opinions on fertility treatments. <ref name="pmid10884536">{{cite journal| author=Schenker JG| title=Women's reproductive health: monotheistic religious perspectives. | journal=Int J Gynaecol Obstet | year= 2000 | volume= 70 | issue= 1 | pages= 77-86 | pmid=10884536 | doi=10.1016/s0020-7292(00)00225-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10884536  }} </ref>
*Religious leaders' opinions on fertility treatments.
* Infertility caused by DNA defects on the Y chromosome are passed on from father to son. [[Natural selection]] is the primary error correction mechanism that prevents random mutations on the Y chromosome, it also prevents the same defect from passing on to the next generation. Fertility treatments for men with abnormal sperm (in particular [[ICSI]]) only defer the underlying problem to the next male generation.  
*Infertility caused by DNA defects on the Y chromosome is passed on from father to son. If [[natural selection]] is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular [[ICSI]]) only defer the underlying problem to the next male generation.


===Psychological Impact==
===Psychological Impact===
Infertility may have profound psychological effects. Partners may become more anxious to conceive, ironically increasing [[sexual dysfunction]]. Marital discord often develops in infertile couples, especially when they are under pressure to make medical decisions. Women trying to conceive often have [[clinical depression]] rates similar to women who have heart disease or cancer<ref>Domar AD, Zuttermeister PC, Friedman R. ''The psychological impact of infertility: a comparison with patients with other medical conditions.''J Psychosom Obstet Gynaecol. 1993;14 Suppl:45-52. PMID 8142988.</ref>. Even couples undertaking IVF face considerable stress, especially the female partner <ref> Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Kohn FM, Schroeder-Printzen I, Gips H, Herrero HJG, Weidner W.  ''Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI.''  Andrologia. 31 (1999): 27-35.</ref>
* Infertility may have profound psychological effects.  
* Both partners involved are prone to being anxious about conceiving, which itself plays a role in increasing [[sexual dysfunction]].
* Marital discord often develops in infertile couples, especially when under pressure to make medical decisions.  
* Women trying to conceive often have [[clinical depression]] rates similar to women who have heart disease or cancer<ref>Domar AD, Zuttermeister PC, Friedman R. ''The psychological impact of infertility: a comparison with patients with other medical conditions.''J Psychosom Obstet Gynaecol. 1993;14 Suppl:45-52. PMID 8142988.</ref>.  
* Even couples undertaking IVF face considerable stress, especially the female partner.


===Social Impact===
===Social Impact===
* In many cultures, inability to conceive bears a stigma.
* In certain social groups, couples face rejection due to not conceiving and bearing children. Societal rejection may cause depression or anxiety in couples involved.


In many cultures, inability to conceive bears a stigma. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way <ref>Schmidt et al. "The Social Epidemiology of Coping with Infertility." Human Reproduction. 20 (2005): 1044-1052.</ref>.  
===Legal Impact===
* There are legal ramifications around infertility as well. Ownership of frozen embryos is a much debated issue, particularly after the time of storage has lapsed. <ref name="pmid12611403">{{cite journal| author=Sheinbach DM| title=Examining disputes over ownership rights to frozen embryos: will prior consent documents survive if challenged by state law and/or constitutional principles? | journal=Cathol Univers Law Rev | year= 1999 | volume= 48 | issue= 3 | pages= 989-1027 | pmid=12611403 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12611403  }} </ref>
* Some courts have ruled to grant frozen embryos all legal rights which are granted to living humans since they have the potential to be born.<ref name="pmid12849802">{{cite journal| author=Schuster TG, Hickner-Cruz K, Ohl DA, Goldman E, Smith GD| title=Legal considerations for cryopreservation of sperm and embryos. | journal=Fertil Steril | year= 2003 | volume= 80 | issue= 1 | pages= 61-6 | pmid=12849802 | doi=10.1016/s0015-0282(03)00503-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12849802  }} </ref>
* Some other courts have granted frozen embryos a ''property'' status, which means they are similar to any other human tissue as property.
* The third position some courts have ruled on is that frozen embryos deserve certain, but not all rights as they are neither property nor full fledged human beings before birth.
* Around 4 million workers in the U.S. used the Family and Medical Leave Act (FMLA) in 2004 to care for a child, parent or spouse, or because of their own personal illness. Many treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for FMLA leave.


There are legal ramifications as well.  Infertility has begun to gain more exposure to legal domains.  An estimated 4 million workers in the U.S. used the Family and Medical Leave Act (FMLA) in 2004 to care for a child, parent or spouse, or because of their own personal illness. Many treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for FMLA leave.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[category:Primary care]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
 
[[Category:Disease]]
[[Category:Disease]]
[[Category:Gynecology]]
[[Category:Gynecology]]
[[Category:Andrology]]
[[Category:Andrology]]
[[Category:Fertility medicine]]
[[Category:Fertility medicine]]
[[Category:Needs content]]
[[Category:Obstetrics]]
[[Category:Needs overview]]
[[Category:Needs overview]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Latest revision as of 07:31, 23 January 2021

Infertility Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Infertility from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Impact

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Pelvic Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Infertility impact On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

[1]

American Roentgen Ray Society Images of Infertility impact

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA onInfertility impact

CDC on Infertility impact

impact in the news

Blogs on Infertility impact

Directions to Hospitals Treating Infertility

Risk calculators and risk factors for Infertility impact

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Impact

Overview

Infertility has an impact on couples ethically, psychologically and socially.

Ethical Impact

There are several ethical issues associated with infertility and its treatment.

  • High-cost treatments are out of financial reach for some couples.
  • There is debate over whether health insurance companies should include cover for infertility treatment.
  • There is some grey area around the legality and status of embryos fertilized in vitro and not transferred in vivo.[1]
  • Anti-abortion lobby groups oppose the destruction of embryos not transferred in vivo as they believe in the personhood status of embryos, regardless of transfer in vivo or not.
  • IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies,premature birth, and a host of health problems and financial strain due to the same on couples.
  • Religious leaders' have differing opinions on fertility treatments. [2]
  • Infertility caused by DNA defects on the Y chromosome are passed on from father to son. Natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, it also prevents the same defect from passing on to the next generation. Fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation.

Psychological Impact

  • Infertility may have profound psychological effects.
  • Both partners involved are prone to being anxious about conceiving, which itself plays a role in increasing sexual dysfunction.
  • Marital discord often develops in infertile couples, especially when under pressure to make medical decisions.
  • Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer[3].
  • Even couples undertaking IVF face considerable stress, especially the female partner.

Social Impact

  • In many cultures, inability to conceive bears a stigma.
  • In certain social groups, couples face rejection due to not conceiving and bearing children. Societal rejection may cause depression or anxiety in couples involved.

Legal Impact

  • There are legal ramifications around infertility as well. Ownership of frozen embryos is a much debated issue, particularly after the time of storage has lapsed. [4]
  • Some courts have ruled to grant frozen embryos all legal rights which are granted to living humans since they have the potential to be born.[5]
  • Some other courts have granted frozen embryos a property status, which means they are similar to any other human tissue as property.
  • The third position some courts have ruled on is that frozen embryos deserve certain, but not all rights as they are neither property nor full fledged human beings before birth.
  • Around 4 million workers in the U.S. used the Family and Medical Leave Act (FMLA) in 2004 to care for a child, parent or spouse, or because of their own personal illness. Many treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for FMLA leave.

References

  1. Koeferl Puorger UP, Buergin M, Wunder D, Crazzolara S, Birkhaeuser MH (2006). "Surplus embryos in Switzerland in 2003: legislation and availability of human embryos for research". Reprod Biomed Online. 13 (6): 772–7. doi:10.1016/s1472-6483(10)61023-1. PMID 17169194.
  2. Schenker JG (2000). "Women's reproductive health: monotheistic religious perspectives". Int J Gynaecol Obstet. 70 (1): 77–86. doi:10.1016/s0020-7292(00)00225-3. PMID 10884536.
  3. Domar AD, Zuttermeister PC, Friedman R. The psychological impact of infertility: a comparison with patients with other medical conditions.J Psychosom Obstet Gynaecol. 1993;14 Suppl:45-52. PMID 8142988.
  4. Sheinbach DM (1999). "Examining disputes over ownership rights to frozen embryos: will prior consent documents survive if challenged by state law and/or constitutional principles?". Cathol Univers Law Rev. 48 (3): 989–1027. PMID 12611403.
  5. Schuster TG, Hickner-Cruz K, Ohl DA, Goldman E, Smith GD (2003). "Legal considerations for cryopreservation of sperm and embryos". Fertil Steril. 80 (1): 61–6. doi:10.1016/s0015-0282(03)00503-x. PMID 12849802.

Template:WikiDoc Sources