Mahon Evelyn, Cotter Noelle
Hum Fertil (Camb). 2014 Sep;17(3):165-9. doi: 10.3109/14647273.2014.948498.
This article describes the experiences of twelve Irish couples who had successful IVF treatment in Ireland. Irish Medical guidelines specify that IVF may only be used when no other treatment is likely to be effective. This article is based on data drawn from a longitudinal research study by Cotter (2009) which tells the stories of 34 couples who sought fertility treatment. Initially, the women assumed that they would become pregnant when they stopped using contraception. As a couple, it was the 'right time' for them to have a child--they were ready, socially and financially. For several months they were patient, hoping it would happen naturally. With envy and some despair they watched as their friends had babies. Infertility came as a shock to most of them. They were reluctant to talk about it to anyone, and over time their anxieties were accompanied by feelings of regret, stigma and social exclusion. They finally sought medical treatment. The latter involved a series of diagnostic treatments, which eventually culminated in IVF which offered them a final chance of having a 'child of their own'. While IVF can be clinically assessed in terms of cycle success rates, their stories showed treatment as a series of discoveries, as an extensive range of diagnostic tests and procedures helped to reveal to them where their problems might lie. They described their treatments as a series of sequential 'hurdles' that they had to overcome, which further strengthened their resolve to try IVF. Much more knowledgeable at that stage, they embraced IVF as a final challenge with single minded dedication while drawing on all their psychological and biological resources to promote a successful outcome. Of the 34 couples who took part in the study, twelve got pregnant. Unfortunately, two children died shortly after birth but eighteen babies survived (see Table I). The findings suggest that health policy should raise awareness of infertility, and advise women to become aware of it--just as in the past, when health policy addressed contraception. Increased public knowledge would reduce the stigma attached to the inability to have a baby. In the Irish case, infertility diagnosis should be reviewed with a view to giving eligible couples earlier access to IVF.
本文描述了十二对在爱尔兰成功接受试管婴儿治疗的爱尔兰夫妇的经历。爱尔兰医学指南规定,只有在其他治疗可能无效时才能使用试管婴儿技术。本文基于科特(2009年)的一项纵向研究得出的数据,该研究讲述了34对寻求生育治疗的夫妇的故事。最初,这些女性认为停止使用避孕措施后就会怀孕。作为夫妻,对他们来说是生育孩子的“合适时机”——他们在社会和经济方面都已做好准备。几个月来,他们耐心等待,希望自然受孕。他们羡慕又有些绝望地看着朋友们生孩子。不孕对他们中的大多数人来说是个打击。他们不愿和任何人谈论此事,随着时间的推移,他们的焦虑伴随着懊悔、耻辱和社会排斥感而来。他们最终寻求医疗治疗。后者包括一系列诊断性治疗,最终以试管婴儿技术告终,这为他们提供了拥有“自己孩子”的最后机会。虽然试管婴儿技术可以从周期成功率方面进行临床评估,但他们的故事表明,治疗是一系列的发现,因为广泛的诊断测试和程序有助于向他们揭示问题可能所在之处。他们将自己的治疗描述为一系列必须克服的连续“障碍”,这进一步坚定了他们尝试试管婴儿技术的决心。在那个阶段他们了解了更多知识,全心全意地将试管婴儿技术视为最后的挑战,同时调动他们所有的心理和生理资源以促成成功的结果。参与该研究的34对夫妇中,有12对怀孕了。不幸的是,两个孩子出生后不久就夭折了,但18个婴儿存活了下来(见表一)。研究结果表明,卫生政策应提高对不孕症的认识,并建议女性了解不孕症——就像过去卫生政策涉及避孕问题一样。公众知识的增加将减少与无法生育相关的耻辱感。就爱尔兰的情况而言,应重新审视不孕症诊断,以便让符合条件的夫妇更早地获得试管婴儿技术治疗。