Psychogenic infertility--myths and facts.
OBJECTIVE
The hypothesis of this review is that the role of psychological factors as the sole cause of infertility is generally overrated.


METHODS
A review is given of studies concerning the influence of psychological factors on the development of infertility.


RESULTS
A prevalence of psychogenic infertility of 10-15 per cent must be discussed critically. A value of approximately 5 per cent is more realistic. Equating unexplained infertility with psychogenic infertility is not justified. A definition of psychogenic infertility according to the German guidelines Psychosomatics in Reproductive Medicine is presented. Spontaneous pregnancies following adoption or the decision to remain childless are the absolute exception. The association of stress and infertility in humans is still unclear. For many women the effect of infertility and notably of medical therapy is a considerable emotional stress. This may make psychosocial counseling necessary in certain cases.


CONCLUSIONS
An exclusive psychological/psychodynamical point of view on the complexity of infertility is as inadequate as a strictly somatic point of view. Infertility should always be treated as a psychosomatic entirety.
Wischmann
Tewes H
TH
Department of Medical Psychology, Heidelberg University Medical School, Bergheimer Strasse 20, D-69115 Heidelberg, Germany. tewes.wischmann@med.uni-heidelberg.de
D003376:Counseling / Q000592:standards; D005260:Female; D005306:Fertilization; D006801:Humans; D007247:Infertility, Female / Q000209:etiology* / Q000523:psychology*; D007248:Infertility, Male / Q000209:etiology* / Q000523:psychology*; D008297:Male; D027724:Reproductive Techniques, Assisted / Q000523:psychology