Psychological burden prediction based on demographic variables among infertile men with sexual dysfunction / 亚洲男科学杂志(英文版)

There has been increasing interest in the psycho-socio-relational and sexual disorders of infertility, as the risk of psychological burden among infertile men with sexual dysfunctions is significant. The purpose of this study was to develop and to validate a predictive model to estimate individual psychological burden among infertile men with sexual dysfunction and study the association between them. Comprehensive data were collected for infertile men (n = 480) who sought treatment for infertility in a reproductive medicine center between June 2012 and December 2013. Using independent predictors of psychological burden from the least absolute shrinkage and selection operator, univariable and multivariable analyses were developed into two models. Predictive accuracy was compared between the models. We explored the association between sexual dysfunction and psychological burden. A total of 480 patients were analyzed using 10-fold cross-validation. Independent predictors of psychological burden were incorporated into a model to measure anxiety (corrected-area under curve (AUC): 77.3%) and a model to measure depression (corrected-AUC: 70.2%). Anxiety and depression were both associated with erectile dysfunction (P < 0.05), with anxiety demonstrating the strongest association. Only anxiety was associated with premature ejaculation (P < 0.05). Premature ejaculation was not found to be associated with depression (P > 0.05). Predictive models for psychological burden among infertile men with sexual dysfunction are presented, and we found that there is an association between psychological burden and sexual dysfunction. According to the models, proper counseling and treatment of sexual dysfunction in infertile men may reduce the psychological burden, help attain natural pregnancy, and improve the quality of life.

Homens que vivenciam a infertilidade: clientes da "cegonha tecnológica" / Men who experiences infertility: clients of "stork technological" / Hombres que experimentan la infertilidad: clientes de la "cigueña tecnologica"

A presente pesquisa teve como objetivo compreender a experiência de homens inférteis, os quais participam de um serviço de Reprodução Assistida. De natureza qualitativa, esta investigação está afinada à perspectiva fenomenológica hermenêutica, privilegiando a compreensão interpretativa fundada na Hermenêutica Filosófica, proposta elaborada por Gadamer. Para acesso à experiência utilizaram-se a entrevista narrativa e os registros feitos no "diário de bordo" das pesquisadoras, a partir da sua inserção no lócus da pesquisa. Os relatos dos colaboradores apontaram para dificuldades vividas durante a tentativa de métodos de Reprodução Assistida, as quais levaram a experiências de desconforto, estranheza, bem como de desesperança frente à burocracia e morosidade dos serviços prestados no hospital. Os interlocutores narraram sua vivência frente aos procedimentos técnicos/médicos, desvelando de um lado a utilidade da técnica no projeto parental e, de outro, o seu domínio na hegemonia do discurso científico e na compreensão do corpo masculino como matéria-prima a ser explorada e aperfeiçoada.

This research aimed to understand the experience of infertile men, who participate in a Assisted Reproduction Service. Qualitative, this research is in tune to the hermeneutic phenomenological perspective, focusing on interpretive understanding founded in Philosophical Hermeneutics, proposal made by Gadamer. For access to the experience we used the narrative interviews and the records made in the "logbook" of the researchers, from its insertion into the locus of research. The accounts of the employees pointed to difficulties experienced while trying to assisted reproduction methods, which led to discomfort experiences, strangeness, and of hopelessness against the bureaucracy and slowness of services in the hospital. The interlocutors narrated his experience forward to the technical /medical procedures, unveiling the one hand the technical usefulness of the parental project and on the other, its dominance in the hegemony of scientific discourse and understanding of the male body as a raw material to be exploited and improved.

Esta investigación tuvo como objetivo comprender la experiencia de los hombres infértiles, que participan en un Servicio de Reproducción Asistida. Cualitativa, esta investigación está en sintonía con la perspectiva fenomenológica hermenéutica, centrándose en la comprensión interpretativa fundada en la hermenéutica filosófica, propuesta hecha por Gadamer. Para el acceso a la experiencia se utilizaron las entrevistas narrativas y los registros realizados en el "cuaderno de bitácora" de los investigadores, a partir de su inserción en el locus de la investigación. Las cuentas de los empleados señalaron las dificultades experimentadas al tratar de los métodos de reproducción asistida, lo que llevó a la incomodidad experiencias, extrañeza, y de desesperanza contra la burocracia y la lentitud de los servicios en el hospital. Los interlocutores narran su experiencia con interés los procedimientos técnicos /medicina, revelando un lado la utilidad técnica del proyecto de los padres y por el otro, su dominio en la hegemonía del discurso científico y la comprensión del cuerpo masculino como materia prima para ser explotados y mejorado.

Representações sociais das profissionais de saúde que trabalham com reprodução humana: um olhar sobre a infertilidade no homem / The social representation evoked by health professionals working in Human Reproduction with men having difficulty procreating with respect to male infertility

Infertilidade masculina tem assumido dimensões importantes no mundo contemporâneo, que também envolve aspectos psicossociais que precisam ser reveladas. Não podendo mais ser tratada apenas pelo prisma biológico, desenvolvemos este trabalho, tendo como objetivos: Descrever as representações sociais (RS) evocadas pelas profissionais de saúde que trabalham em reprodução humana (RH), atendendo homens com dificuldade para procriar com relação à infertilidade no homem; Analisar as RS desveladas nos discursos desses profissionais sobre a dificuldade para procriar no homem e; Discutir as RS da dificuldade para procriar no homem, desveladas nos discursos destes profissionais referentes ao atendimento prestado. Metodologia: A pesquisa é qualitativa, descritiva, na perspectiva da Teoria das Representações Sociais de Moscovici. Utilizamos como método para análise dos dados a Analise de Conteúdo de Bardin a fim de responder as seguintes questões: Como as profissionais de saúde que trabalham em RH representam a dificuldade para procriar no elemento masculino? Como esses profissionais vêem os homens que vivem a situação de dificuldade para procriar? Como lidam com a dificuldade para procriar do homem no cotidiano de seu trabalho? As RS que esses profissionais têm da dificuldade para procriar do homem interferem no seu atendimento? Há relação entre formação acadêmica e a qualificação profissional em saúde sexual e reprodutiva e as RS referentes à dificuldade para procriar do homem? São sujeitos 20 profissionais de saúde de nível superior, divididos em dois grupos de pertença área humana e biomédica que trabalham com RH a pelo menos um ano e atendem homens com dificuldades de procriar. Os cenários foram dois ambulatórios de RH públicos no Rio de Janeiro. Como técnicas de coleta de dados foram utilizadas a Associação Livre de Idéias, com os termos indutores: “masculinidade”, “paternidade” e “infertilidade” e; a entrevista semi-estruturada...

Mental health status of infertile couples based on treatment outcome

Infertility is accompanied by numerous psychological and social problems. Infertile couples are more anxious and emotionally distressed than other fertile people. Previous studies suggested that infertility is more stressful for women than men. The purpose of this study was to determine the status of general health of infertile couples. This cross-sectional study evaluated general health of 150 infertile couples attending to Yazd Research and Clinical Center for Infertility that were selected consequently. The data were gathered by the researchers, based on face to face interview before and after three months of treatment by two questionnaires. The first questionnaire had questions on demographic information and the second one was the General Health Questionnaire-28 [GHQ-28]. This questionnaire has four sub- scales areas. All data were transferred directly to SPSS 15 and analyzed. The mean age of women was 28.3 and men were 32.4 years. The scores for all sub- scales of GHQ in women were more than men. There was significant difference between age and general health at physical symptoms scales [p=0.002], anxiety and sleep disorders [p=0.003]. The age group 25-29 years had higher scores [more than 7] than other age groups. There was significant difference between the scale of social dysfunction and results of treatment. Our results, similar to the previous studies have revealed negative social and mental effects of infertility on women is more than men, so there is need that they be educated specially

Gender differences in infertility-related stress and the relationship between stress and social support in Thai infertile couples.

OBJECTIVE: To study infertility-related stress among men and women and to examine its relationship with the level of perceived social support. MATERIAL AND METHOD: The Fertility Problem Inventory (FPI) and the Personal Resource Questionnaire (PRQ) were translated into Thai and used to assess the level of infertility-related stress and perceived social support, respectively, in 238 infertile subjects. RESULTS: The global FPI scores for men and women were 154.2 +/- 18.3 and 154.7 +/- 22.6, respectively (p > 0.05). There was no significant difference in their perceived social support (PRQ scores = 137.8 + 14.0 and 134.0 +/- 16. 7 respectively). A significant negative correlation (r = -0.1894; p < 0.001) existed between global stress and social support in women, but not in men. CONCLUSION: Thai infertile couples experienced a high level of stress. Unlike previous studies from Western countries, there was no gender diference in infertility-related stress.

Avaliação da eficácia adaptativa de mulheres e homens inseridos num programa de fertilização in vitro / Evaluation of adaptive efficacy of men and women inserted in an in vitro fertilization programme

Avaliar a eficácia adaptativa de homens e mulheres inseridos em programa de fertilização in vitro (PFIV). Método: Foram avaliados 57 casais inférteis, de Centro de Reprodução Humana, no período de março a outubro de 2002. Questionário foi empregado para avaliar os dados sócio-demográficos. A Escala Diagnóstica Adaptativa Operacionalizada (EDAO) foi utilizada para o diagnóstico da adaptação. Para a análise estatística foram utilizados os testes T Student e Qui-quadrado. Adotou-se nível de significância de 5 por cento. Resultados: apesar das dificuldades, homens apresentaram melhor adaptação do que as mulheres, segundo itens da EDAO. No diagnóstico, 64.9 por cento dos homens e 52.6 por cento das mulheres foram classificados nos grupos "Adaptação Ineficaz Leve" e "Adaptação Ineficaz Severa", respectivamente (p=0.000). Verificou-se que 20.2 por cento dos sujeitos estavam em crise, sendo 8,8 por cento dos homens e 31,6 por cento das mulheres (p=0.002). Concluiu-se que os homens possuíam melhor eficácia adaptativa em relação às mulheres durante PFIV. Sugere-se acompanhamento psicológico preventivo e intervenções específicas, para os momentos de crise.

To evaluate the adaptive efficacy of men and women inserted in an in vitro fertilization program (IVFP). Methods: Fifty-seven couples were evaluated, being 57 infertile women and their respective fertile partners, from March to October of 2002, from a Center of Human Reproduction. Questionnaire was employed to elicit socio-demographic data. The Operationalized Adaptive Diagnostic Scale (EDAO) was used for the diagnosis of adaptation. Statistical analysis was performed using T test and qui-square test. A significance level of 5 percent was adopted. Results: Regardless presenting few difficulties, men showed a better adaptation than women. Regarding the diagnosis, 64.9 percent men and 52.6 percent were classified in "Light Ineffective Adaptation" and "Severe Ineffective Adaptation", respectively (p=0.000). It was observed that 20.2 percent of the subjects were in crisis: 8.8 percent of the men and 31.6 percent of the women (p=0.002). Conclusions: Men had a better adaptive efficacy compared to the women during IVFP. It was suggested the need for preventive psychological attendance, and specific interventions during the crisis.

El trabajo tuvo como objetivo evaluar la eficacia adaptativa de hombres y mujeres inseridos en el Programa de Fertilización In Vitro (PFIV). Fueron evaluados 57 parejas infértiles, del Centro de Reproducción Humana, en el período de marzo a octubre de 2002. Fue utilizada una encuesta para evaluar los datos sociales-demográficos. La Escala Diagnóstica Adaptativa Operacionalizada (EDAO) fue utilizada para el diagnóstico de la adaptación. Para el análisis estadístico fueron utilizados los testes T de Student y Chi-Cuadrado. Se adoptó el nivel de significancia del 5 por ciento. Se observó como resultado que, pese a las dificultades, los hombres presentaron mejor adaptación, comparados a las mujeres, según ítemes da EDAO. En el diagnóstico, el 64.9 por ciento de los hombres y el 52.6 por ciento de las mujeres fueron clasificados en los grupos "Adaptación Ineficaz Leve" y "Adaptación Ineficaz Intensa", respectivamente (p=0.000). Se verificó que el 20.2 por ciento de las personas estaban en crisis, siendo el 8,8 por ciento de los hombres y el 31,6 por ciento de las mujeres (p=0.002). Se concluyó que los hombres tenían mejor eficacia adaptativa que las mujeres durante el PFIV. Se sugiere seguimiento psicológico preventivo e intervenciones específicas, para los momentos críticos.

Evaluating stigma among infertile men and women in Iran

Psycho-social aspects of physical disability may create more problems for the individual than the disability itself. The infertile may suffer from misjudgments or prejudices in different situations by their colleagues and relatives. All factors for this suffering can be evaluated in stigma settings which the infertile confront. In addition to these pathological settings, there are some opportunities which infertile people can enjoy for more adaptations with their social environments. The objective of this study was to become familiarized with different aspects of psycho- social life of the in fertile in the setting of Iranian culture. 268 fertile and infertile subjects were involved in this study from two different regions of Iran. Through a considerable number of interviews with infertile individuals in the pilot study, the styles of social interaction with people and also positive and negative constructs related to their social lives were recognized. Utilizing a suitable instrument [Repertory grid] and factor analysis of scores, disability factors concerning social aspects of infertility were discovered. Moreover, regression analysis and t-test [p<.05] were used for the analysis of the data. The statistical analysis including t-test, factor and regression analyses indicated that social comparison, as one of the sources for self, has an imminent role in the prediction of psychosocial adjustment of infertile individuals. Meanwhile, the infertile women showed more negative views in the elements "comparison with fertile people" and "my view toward infertility" but both fertile and infertile subjects did not show any significant differences in psychosocial adjustments. From the three sources of self-knowledge, social comparison, social feedback and self-observation, social comparison plays the first role and social feedback the second in the construction of stigma among infertile people. The results of this study showed the necessity of a health-oriented approach in the evaluation of psycho-social aspects of physical disability among infertile people and also the necessity of modifying and equalizing the functions of the three sources of self-knowledge through group therapy sessions

Attitude towards infertility and its relation to depression and anxiety in infertile couples

Different psychological aspects of infertility have been studied so far. The objecttive of this study was to determine the most common dimensions of attitude towards infertility in infertile couples and also to determine the relation between attitude towards infertility and age of couples, the time-span after marriage, educational achievements and infertility variables. Another objective of the study was to determine the relation between attitude towards infertility and degrees of depression and anxiety. Among people who referred to Fertility and Infertility Center in Isfahan in autumn 2004, 55 cases [25 men and 30 women], who had neither children nor any adoption child but had been diagnosed infertile, were randomly selected and were asked to answer attitude towards infertility questionnaire and Beck s depression and anxiety inventories. The data were analyzed by SPSS software. Statistical methods such as correlation, descriptive analysis, variance and multiple regression analyses were employed. Based on the findings of the study, attitude towards having offspring and parental role with 69.1%, and attitude towards social acceptance with 54.5%, were the most prevalent dimensions of attitude towards infertility. In addition, attitude had a significant [p<0.05] reverse relation to age but had no significant relation to time-span after marriage or the participants' educational levels. Results did not show significant differences in attitude towards infertility, when the participant, his/her spouse or both of them were infertile. Noting the regression analysis results, attitude towards life control and social acceptance are the most important factors determining depression severity [p<0.0001], where life control, social acceptance, having offspring and parental role had greater effects on anxiety [p<0.0001]. Many infertile couples put the highest emphasis on offspring and parental role and most of them had negative attitude towards social acceptance. Older people had less negative attitudes towards the variables. The participants' attitude towards infertility had no relation to timespan after marriage, educational levels or whether the participant, his/her spouse or both were infertile. Depression and anxiety in these couples were due to their attitude towards life control and social acceptance

O impacto emocional da infertilidade conjugal / The emotional impact of conjugal infertility

A infertilidade afeta cerca de 20 dos casais e tente a gerar ansiedade, desilusão, sensação de fracasso e insatisfação pessoal ou conjugal que, em grande parte, pode contribuir ainda mais para o insucesso gestacional. O método utilizado foi a revisão bibliográfica não sistemática sobre o tema abordado, utilizando-se a base de dados do MEDLINE e Scielo. O casal que busca auxílio médico por infertilidade traz inúmeras motivações algumas conscientes, porém muitas inconsciente. O desejo de ter um filho pode expressar desde uma ato criador e produtivo, como o desejo de imortalidade e realização de projetos através da prole, até a busca de preencher lacunas, recuperar casamentos ou atender a pressões sociais ou familiares. O impacto da infertilidade no casal pode evidenciar problemas individuais não resolvidos e tende a abalar relacionamentos conjugais. Estudos têm demonstrado que o estresse diminui o sucesso das implantações na fertilização assistida, o que torna essencial a avaliação e acompanhamento psicológico para estes casais. Por outro lado, casais que, mesmo assim, não conseguem gestar devem ser auxiliados a elaborar a perda e reestruturarem suas vidas. O medo do homem e/ou da mulher infértil perder o cônjuge por não poder satisfazê-lo, pode alterar todo vida do casal, que passa a viver em torno de exames, diagnósticos e tratamentos. Outro problema é encarar o sexo como tarefa, dissociando-o do prazer, com conseqüente redução da satisfação e freqüência sexual.

Mental health predictive factors in infertile couples

Infertility affects different aspects of the individual's life and perhaps it is one of the main life stressors. Individuals under major stress are more exposed to disease such as depression, anxiety, low self confidence and dissatisfaction. The present study focuses on the role of gender on mental health in infertile couples. The sample was 50 infertile couples. The results indicated, infertile women have more psychological problems than infertile men, perceive infertility as more negative than men and hope to the future and to marital life, and the sense of meaning in life have determining roles in predicting mental health of infertile couples

Psychosocial aspects of infertility from viewpoint of infertility treating physicians

Infertility phenomenon extra to medical science territory has been studied in the fields of behavior and social sciences. Infertility as a psychological crisis, has a lot if stress on infertile couples and in different ways, has threatened their mental health. Considering high expenses of fertility in Iran with its socio-cultural aspects, especially for women, has propounded special importance for studying of infertility phenomenon from psychological-social aspects. This research, as preliminary study, has studied viewpoint of Iranian physicians and specialists involved on infertility which have beneficial experiences in regard if infertile couples, as one if most important and reliable resources for cultural-social studies of infertility. This study is a purposive research which by design of psychological-social primary problems in infertility, it investigate the recognition if role if psychological-social factors from view point of Iranian physicians and recognition rate of importance of psychological-social problems with these physicians. In this way infertile couples get more psychological-social supports and also in respect of economical it prevent expending unnecessary time and expenses or performing improper medical treatments and it can accompany the medical treatments with more effective results. After validity inspection of sandbi questionnaire [1997] in primary study, for studying psychological-social factors involved in infertility, questionnaire with 40 questions was prepared and was delivered to 120 physicians and specialist of different fields involved in infertility affairs [Obs and Gyn, Urology, Embryology, Infectious disease and General practitioner]. Findings of this descriptive research showed that infertile on the viewpoint of Iranian physicians of infertile community in Iran, which needs more attention. Also, from their point of view, infertile communities belong to families with low income and infertility treatments enforce high expenses to them. Most common emotional and psychological problems of infertile couples were despair, frustration, fear and anxiety. It is has been accompanied in less cases with rage and violence. These problems, with familial and social problems, such as suspension of marital relations and conflicts such as second marriage, separation and divorce are of important matters, which make the psychological consultation services very important and vital. Hopelessness and despair, fear and anxiety, are important psychological factor diseases. Women are more than men patent to psychological hams in this regard. In view point of physicians, stress and glumness in causing infertility, consultation and psychological treatment and awareness of details of diagnostic and remedial proceedings in treatment and improvement of infertility, has effective role and presence of psychiatrist and consultant seem to be necessary in different treatment and clinical infertility wards. In this way, necessary psychological interventions will be provided in all process of before, during and after treatments

Infertilidade e Emoçäo / Infertility and Emotion

Os aspectos psicológicos vivenciados pelos casais inférteis apresentam certas particularidades, podendo interferir na relaçäo do casal, nas relaçöes familiares e sociais e, em alguns casos, também no desempenho profissional. O conhecimento destas particularidades é de fundamental importância para que possamos ajudar esses casais durante o tratamento de infertilidade

La consulta médica en infertilidad: posibilidad de encuentros / The medical consultation in infertility: possibility of encounters

La propuesta en éste trabajo es comentar las viscisitudes de la consulta médica con las parejas que presentan imposibilidad de concebir un hijo. La contratransferencia del médico, los afectos que se ponen en juego con y desde los pacientes. Además se trata de articular el campo médico y el psicológico, pensando que desde la interdisciplina el abordaje de ésta problemática es posible. Tomamos la consulta como momento de encuentro de saberes, de desconocimiento y de afectos

Estudio comparativo de los efectos psicológicos de la infertilidad en hombres y mujeres chilenos / Comparative study of the psychological effects of the infertility in chilean men and women

La infertilidad produce un fuerte desgaste emocional en las parejas que la padecen.Los efectos en la mujer han sido previamente estudiados, pero se desconoce la vivencia masculina de la infertilidad. El objtivo de este estudio fue comparar la reacción emocional de marido y mujer frente a su problema de infertilidad conyugal. Se evaluaron 107 parejas tratadas en dos centros de infertilidad (Policlínico y Programa de Fertilización in vitro) mediante un cuestionario. Se observó que las mujeres, en general, mostraron un mayor desajuste personal que sus maridos. Al considerar la procedencia, se vio que las parejas del Grupo Policlínico estaban más afectadas emocionalmente que las parejas del Grupo de Fertilización in vitro. Al ajustar estas diferencias por: nivel de educación, duración de la relación de pareja, duración de la infertilidad y edad, se vio que la edad tuvo un efecto atenuante del desajuste emocional. Se comentan estos resultados en relación a la naturaleza de las terapéuticas médicas y a factores sociales

Prueba para la evaluación psicológica en mujeres con trastornos de la fertilidad / A test for psychologic evaluation of women with fertility disturbances

Los aspectos emocionales intervienen en los trastornos de las parejas estériles, pero generalmente el médico los minimiza y esto condiciona o agrava alteraciones conductuales y afectivas, agregándose en consecuencia otros problemas en el curso del tratamiento. Se acepta que el factor piscológico está presente en la mayoría de las parejas con trastornos de la fertilidad hasta en 5 por ciento de ellas. En este trabajo se presenta una prueba para la evaluación psicológica de las mujeres con alteración de la fertilidad, con el propósito de que el médico pueda determinar más objetivamente cuáles necesitan asistir a consulta con psicólogo. Para facilitar la detección de ansiedad, depresión y disfunción sexual, se ideó un cuestionario de ocho preguntas abiertas que se aplicaron a 50 mujeres, con el fin de identificar a las pacientes con algunos problemas no manifiestos. Con esta prueba, la reacción psicológica más frecuente fue la ansiedad, detectada claramente en 16 pacientes y en forma dudosa en 28. La ansiedad se asoció a la disfunción sexual en 23 mujeres. La interpretación global de la respuesta reveló que 14 pacientes necesitaban asistencia psicológica, diez requerían una entrevista inicial diagnóstica y 26 no ameritaban dicha evaluación. Los resultados preliminares de este protocolo indican que estos criterios permiten al médico una selección más objetiva de las parejas con problemas picológicos, los cuales generalmente pasan inadvertidos

Maternidad, esterilidad y tecnología reproductiva / Maternity, sterility and reproduction technology

La noción de maternidad (como la de paternidad) transciende del ámbito de la reproducción biológica, en tanto pone en juego el deseo de un sujeto y está regulada por el universo simbólico: lenguaje, mitos, normas y valores propios de una cultura. En esta perspectiva, la infertilidad no puede considerarse como enfermedad corporal sino como problema humano de dimensión psicológica y social que requiere una búsqueda de soluciones que no pueden limitarse a una intervención médica. El auge de las nuevas tecnologias reproductivas se inscribe en la lógica de la tecnologización creciente de nuestra y, en especial, en el marco de la medicalización cada vez mayor de la vida, la sexualidad y la gestión de los cuerpos humanos

effect of psychological stress on hormones in infertile men undergoing varicocele ligation

Varicocele is considered a sort of chronic stress to the testis. There is a significantly increased percentage of tappered sperm in varicocele patient semen which is called stress pattern of sperm morphology. The aim of this work was to study the effect of stress on reproductive hormones in infertile males. Special group of infertile patients with varicocele were chosen. The study included 20 infertile patients undergoing varicocelectomy. Two blood samples were taken from each individual to detect the effect of operation stress on hormones. The following hormones were assayed: LH, testosterone FSH and prolactin. It was found that there is insignificant increase in serum testosterone, LH and prolactin. While serum FSH was significantly increased in the sample taken immediately before operation. This increase can be explained by disruption of the testis by stress with subsequent alteration in testosterone biosynthesis and/ or inhibin. When inhibin release is reduced, it stimulates the release of FSH from pituitary cells by feedback mechanism

Aspectos emocionais na infertilidade masculina / Emotional aspects in male infertility

A autora estuda uma amostra de 15 pacientes masculinos inférteis, verificando que todos os casos apresentam sintomatologia psiquiátrica, de intensidade variada, com ansiedades depressivas e paranóides; observa o uso da negaçäo e projeçäo. Constata que a infertilidade masculina se associa com fantasias de castraçäo, em alguns casos claramente relacionadas ao conflito edípico. Verifica que a mulher costuma assumir a responsabilidade pela infertilidade conjugal e tece consideraçöes a esse respeito. Ficam várias questöes em aberto para investigaçöes futuras