title: The many facets of involuntary childlessness in general practice.
abstract: OBJECTIVE
  To obtain a vivid picture of involuntary childlessness in general practice so that the doctor becomes aware of the frequency and the forms of childlessness.
  
  
  METHODS
  Analysis of in-depth interviews.
  
  
  METHODS
  General practices in the area of Göttingen, Germany.
  
  
  METHODS
  35 patients (27 females) who described themselves as involuntarily childless.
  
  
  METHODS
  Family status, reason for childlessness as seen from the patient's perspective, treatment status, and expectations towards the general practitioner (GP).
  
  
  RESULTS
  Eleven patients had one or more children resulting, either from the present partnership or from a previous partnership. A deficient hormone status (7 patients) and tubal disorders (7) were most frequently reported by the patients. Some patients reported several reasons. In four cases, childlessness was directly or indirectly caused by problems within the partnership. Only eight interviewees or their partners were receiving active treatment at the current time. An additional eight couples had been previously treated. Medical information and emotional support were most often expected from the GP, but not always received--because of lack of time, lack of trust or lack of initiative on the doctor's part.
  
  
  CONCLUSIONS
  Since social reasons, problems with the partnership or anxieties may cause childlessness or may be associated with somatic causes, the GP should consider infertility in the broader context of family medicine. Although not all childless patients do expect immediate diagnosis, referral and treatment for their condition, they are often waiting for the GP's initiative to talk about their problems.
authors.affiliation: Department of General Practice, University of Göttingen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Himmel
authors.forename: E
authors.initials: E
authors.lastname: Ittner
authors.forename: M
authors.initials: M
authors.lastname: Schroeter
authors.forename: M M
authors.initials: MM
authors.lastname: Kochen
mesh_terms: D000328:Adult; D005194:Family Practice; D005260:Female; D005858:Germany; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations