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Psychogene Fertilitätsstörungen

Mythen und Fakten

  • Übersicht
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Es wird ein Überblick über den aktuellen Forschungsstand zur Bedeutung psychosozialer Faktoren bei der Genese von Fruchtbarkeitsstörungen gegeben. Hypothese ist, dass der Einfluss psychologischer Faktoren als alleinige Ursache von Infertilität im Allgemeinen überschätzt wird. Die Prävalenzangabe psychogener Infertilität von 10–15% muss kritisch diskutiert werden, ein Wert von ca. 5% erscheint realistischer. Idiopathische Infertilität ist nicht gleichzusetzen mit psychogener Infertilität. Die Definition der psychogenen Fertilitätsstörung nach den Leitlinien „Psychosomatik in der Reproduktionsmedizin“ wird vorgestellt. In einem Fallbeispiel wird eine überwiegend psychogene Infertilität beschrieben. Spontanschwangerschaften nach Adoption bzw. Aufgabe des Kinderwunsches sind eine absolute Ausnahme. Die Zusammenhänge von Stress und Infertilität beim Menschen sind noch ungeklärt. Erwiesen ist, dass das Erleben der Infertilität und der reproduktionsmedizinischen Behandlung für viele Frauen eine erhebliche emotionale Belastung darstellt, die in einigen Fällen eine psychosoziale Beratung erforderlich macht. Eine ausschließlich psychologische/psychodynamische Betrachtungsweise ist der Komplexität von Fertilitätsstörungen ebenso wenig angemessen wie eine rein organmedizinische Sicht. Die Fertilitätsstörung sollte immer als psychosomatische Einheit behandelt werden.

Abstract

A review is given of studies concerning the influence of psychological factors on the development of infertility. The hypothesis of this review is that the role of psychological factors as the sole cause of infertility is generally overrated. A prevalence of psychogenic infertility of 10–15% must be discussed critically. A value of approximately 5% is more realistic. Equating idiopathic infertility with psychogenic infertility is not justified. A definition of psychogenic infertility according to the German guidelines “Psychosomatics in reproductive medicine” is presented. In a case report a preponderantly psychogenic infertility is described. 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 represents considerable emotional stress. This may make psychosocial counseling necessary in certain cases. An exclusive psychological/psychodynamic 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.

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Notes

  1. Mit freundlicher Genehmigung des Verlags W. Kohlhammer (Stuttgart) entnommen aus: Wischmann, T. und Stammer, H. (2003) Der Traum vom eigenen Kind. Psychologische Hilfen bei unerfülltem Kinderwunsch. Stuttgart: W. Kohlhammer GmbH (2. Aufl.).

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  1. Abteilung für Medizinische Psychologie, Psychosomatische Universitätsklinik Heidelberg, Heidelberg

    T. Wischmann

  2. Abteilung für Medizinische Psychologie, Psychosomatische Universitätsklinik, Bergheimer Straße 20, 69115 , Heidelberg

    T. Wischmann

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Correspondence to T. Wischmann.

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Dieser Beitrag erschien in kürzerer Form zuerst im Journal of Assisted Reproduction and Genetics. Er basiert auf einem Vortrag auf dem pre-congress course „Psychology and Counselling“ der European Society of Human Reproduction and Embryology (ESHRE) in Wien am 30. Juni 2002.

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Wischmann, T. Psychogene Fertilitätsstörungen. Gynäkologische Endokrinologie 1, 187–196 (2003). https://doi.org/10.1007/s10304-003-0036-3

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