The many facets of involuntary childlessness in general practice

Abstract

Objective - To obtain a vivid picture of involuntary childlessness in general practice so that the doctor becomes aware of the frequency and the forms of childlessness. Design - Analysis of in-depth interviews. Setting - General practices in the area of Gottingen, Germany. Subjects - 35 patients (27 females) who described themselves as involuntarily childless. Main outcome measures - Family status, reason for childlessness as seen from the patient's perspective, treatment status, and expectations towards the general practitioner (GP). Results - Eleven patients had one or more children resulting, either from the present partnership or from a previous partnership. A deficient hormone status (7 patients) and tubal disorders (7) were most frequently reported by the patients. Some patients reported several reasons. In four cases, childlessness was directly or indirectly caused by problems within the partnership. Only eight interviewees or their partners were receiving active treatment at the current time. An additional eight couples had been previously treated. Medical information and emotional support were most often expected from the GP, but not always received - because of lack of time, lack of trust or lack of initiative on the doctor's part. Conclusions - Since social reasons, problems with the partnership or anxieties may cause childlessness or may be associated with somatic causes, the GP should consider infertility in the broader context of family medicine. Although not all childless patients do expect immediate diagnosis, referral and treatment for their condition, they are often waiting for the GP's initiative to talk about their problems.