Introduction

It is important for the physician to recognize the psychological issues involved in fertility treatment. The emotions and attitudes of the couple can be powerful, conflictual and problematic in making decisions regarding the treatment options facing them. The physician must be aware of and understand the patients' feelings/beliefs in order to guide the couple in a direction that will provide a positive outcome.

Intrauterine insemination using husband/partner sperm

A recommendation of intrauterine insemination (IUI) can be difficult for the couple to accept, even if the husband's or partner's sperm is to be used. This relatively low level of intervention may be recommended after a complete fertility evaluation and several months of a couple trying unsuccessfully on their own to achieve a pregnancy. The medical reason for recommending IUI may relate to poor fertility status of the male sperm or poor fertility status of the female reproductive environment, or both.

If the medical diagnosis of infertility rests with the man, he may experience feelings of guilt and doubt about his potency in not being able to impregnate his partner through normal sexual intercourse. Such a diagnosis may affect his sense of masculinity. He may experience feelings of anger because he cannot achieve something, without medical intervention, that should be a natural expression of physical intimacy. The woman may also feel anger and/or resentment toward her partner if the problem lies with his sperm.

If IUI is recommended because of a condition in the woman, she may experience feelings of guilt and inadequacy, and a general lowering of self-esteem.