While fertility rates in Western countries are low and the number of people who will remain voluntarily childless is increasing, more and more couples are seeking medical treatment for infertility. Fertility problems transcend the boundaries of medicine and challenge the traditional positivistic understanding of health and illness and the authority of scientific and objective medicine. The circumstances for coping with infertility are not universal and depend instead on the given society and on cultural values. Studying infertility means studying every important institution of our society: the institutions of marriage and the family, the institution of parenthood, medicine, and so on. While American and other Western social scientists have studied social aspects of infertility for many years, in the Czech Republic the topic remains the domain of medicine. This article focuses on basic concepts employed in the study of infertility and involuntary childlessness in sociology. It presents and summarises relevant concepts such as stigmatisation, social exclusion, identity problems, and gender differences in the response to infertility. It presents the debate over explaining the terms of infertility and (involuntary and voluntary) childlessness. It shows how the position of involuntary childlessness has been changing as the problem has increasingly come to be dealt with in medical terms and as high-tech medical treatments for infertility have been developed. Finally, the article opens up the topic for debate and raises the question of potential methods of research.
There is no separate course in the medical curriculum summarizing all aspects of human reproduction in most medical school curricula. At the same time, such a course would logically connect knowledge from clinical embryology and assisted reproduction, encompassing the issue of female and male infertility, mechanisms of birth defect formation, their prenatal diagnosis and subsequent specialized neonatal care. The aim of a wide team of university teachers comprising embryologists, gynecologists, neonatologists, endocrinologists, geneticists and others was to create and implement a new course entitled "Clinical Embryology and Reproductive Medicine" into the fourth-year curriculum of the study program General Medicine at the Faculty of Medicine, Comenius University in Bratislava. There has been a great interest in the course, as evidenced by the number of medical students enrolled. The lecture syllabuses have been divided into several thematic areas: 1) Clinical embryology including a laboratory part of assisted reproduction, 2) Cause and treatment options of female and male infertility, 3) A comprehensive view of the issue of birth defects, 4) The issue of preconception education, prenatal and childbirth training, family planning, 5) Reproductive immunology and endocrinology. Despite the complexity of human reproduction being a mainstay of gynecology and obstetrics, it is underemphasized in the medical school curricula worldwide. It is often reflected in shorter hospital / practical trainings during undergraduate studies and lower requirements at the final exam. Therefore, as students almost unanimously valued, this new course is extremely helpful in preparing for the final state exam.
Pozdní mateřství je fenoménem současnosti a bývá spojováno s životním stylem moderní společnosti. V zahraniční literatuře o něm bylo již mnoho napsáno, u nás však výzkumy věnující se podrobněji motivům vedoucím k pozdnímu rodičovství chybí. Tuto mezeru se snažila alespoň z části vyplnit diplomová práce, z níž vychází tento článek. Cílem práce bylo formou kvalitativního výzkumu přiblížit motivy žen, které mají své první dítě po pětatřicátém roce věku. Hlavní metodou použitou v tomto výzkumu byl polostrukturovaný rozhovor s deseti ženami. V odborné literatuře je v souvislosti s pozdním rodičovstvím zmiňováno pět základních aspektů: psychologické, sociodemografické, duchovní, biologické, medicínské a ekonomické.
Výzkum neprokázal jednoznačnou dominanci jediného faktoru. U šesti žen je možné hovořit o faktorech medicínských s tím, že z toho u čtyř žen byly tyto faktory kombinovány s hledáním správného partnera a s kariérou. Svou roli hrály také faktory psychologické, většinou v kombinaci s jinými faktory. Z výzkumu vyplývají některé návrhy do praxe. Speciální program pro starší matky by se například měl zaměřit na posílení identity, sebevědomí a rozvoj osobnosti. Ženy by měly dostat také informace týkající se pracovněprávní problematiky. Důležitý je realistický pohled na mateřství a příklon ke zdravému životnímu stylu. and Later motherhood is a present phenomenon, and it’s usually connected with modern life style. There was already a lot of written about this theme in foreign literature. Unfortunately, the studies revealing the motives, which lead to later motherhood in more details, are missing in Czech Republic. This study tries partly to fill this gap, which this article comes from. The aim of it is to introduce the motives of the women who have their first child after their 35th years by qualitative research. The main method used in this research is the semi structured interview with ten women. In professional literature five basic aspects are mentioned in the connection with the later parenthood: psychological, social demographic, spiritual, biological, medical and economical.
The research didn’t prove definite domination of one factor. In six cases, we can talk about medical factors whereas in four cases, these factors were combined with looking for the right partner and with career. The psychological factors played also its role, mostly not separately but in combination with other factors. From the research some proposals result for the practice. The special program for these women, should focus on strengthening of identity, self-confidence and personal development. The women should receive information concerning law-work affairs. They should also receive realistic view on motherhood and healthy lifestyles.
Výzkum je zaměřen na životní spokojenost a copingové strategie žen, které podstupují své první umělé oplodnění. Cílem bylo také vytipovat strategie, které se ukazují pro tuto situaci jako adaptivní nebo neadaptivní. Výzkumu se zúčastnilo celkem 139 žen, které vyplnily Dotazník životní spokojenosti (Fahrenberg, Myrtek, Schumacher, & Brahler, 2001) a Cope Inventory (Carver, Scheier, & Weintraub, 1989) v době začátku své léčby.
Z výsledků vyplývá, že ženy jsou ve srovnání s ostatními aspekty životní spokojenosti nejvíce spokojené se svým partnerstvím, bydlením a sexualitou, nejméně spokojené pak se svým trávením volného času a finanční situací. Z copingových strategií užívají tyto ženy nejčastěji strategie Plánování, Pozitivní reinterpretaci a Aktivní coping. Jako adaptivní strategie pro situaci neplodnosti a její léčby se ukázaly strategie Vyhledávání sociální opory a Pozitivní reinterpretace, naopak strategie Popření se ukázala jako neadaptivní.
Výzkum také naznačuje možné implikace do psychologického poradenství ženám, které se v této situaci nacházejí. and This research is focused on life satisfaction and coping strategies of women undergoing their first IVF treatment. The aim was also to find coping strategies which are adaptive or non-adaptive for this situation. The sample of 139 women filled in two questionnaires: Life satisfaction questionnaire (Fahrenberg, Myrtek, Schumacher, & Brahler, 2001) and COPE Inventory (Carver, Scheier, & Weintraub, 1989) at the beginning of their treatment.
Results show that women are most satisfied with their partnership, housing and sexuality in compared with other aspects of life satisfaction, and they are at least satisfied with their leisure time and financial state. From coping strategies they use the most often Planning, Positive reinterpretation and active coping. As adaptive coping strategies we found Seeking of social support and Positive reinterpretation, on the contrary we found coping strategy Denial not adaptive.
There are some useful implications forms this research for psychological counseling for women undergoing IVF treatment.