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Applied Child Psychology > Infertility, Assisted Reproductive Technology & Parenting > Flashcards

Infertility, Assisted Reproductive Technology & Parenting Flashcards

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1
Q

What is the WHO definition of infertility

A

the failure to conceive after 12 months of trying

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2
Q

what percentage is infertility due to female factors only

A

34%

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3
Q

what percentage is due to male factors only

A

28%

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4
Q

what percentage is due to male and female combined

A

14%

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5
Q

what percentage of infertility is unexplained

A

22%

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6
Q

what are some western cultural changes that have effected having babies

A
  • contraception
  • male/female roles redefined
  • fewer marriages
  • more divorces
  • emphasis on careers for women
  • postponement of first child
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7
Q

discuss choice/control over having babies

A

women & men are choosing to not have babies BUT later ages in deciding to have children means infertility is more common

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8
Q

What did the early psychological research on infertility suggest, how has this evolved

A

that women were psychologically to blame for their infertility - proposed psychogenic origins
-recently growing awareness of the male factor in infertility

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9
Q

in 2011, what percentage of aus babies were a result of IVF

A

3.8% - one child in each classsroom

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10
Q

discuss Verhaak et al., 2006 systematic review of the psychological components of infertility

A
  • few differences b/w ART women and “norms” at treatment outset
  • unsuccessful treatment cycles did increase negative emotions, but most adjust well
  • less is known about long-term adjustment after unsuccessful
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11
Q

what are the 5 different treatments for infertility

A
  • IVF
  • ICSI - intra-cytoplasmic sperm injection
  • donor sperm, eggs, gamtes
  • embryo adoption
  • surrogacy
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12
Q

what’s involved in IVF

A
  • medical investigations
  • ovulation stimulation
  • ultrasound & blood monitoring of egg maturity
  • further hormonal stimulation via injection
  • laparaoscopic egg collection & collection of a sperm sample from the male partner
  • fertilised embryo is transferred to the uterus
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13
Q

discuss ICSI

A
  • the sperm sample is modified

- they get a tiny needle and inject the sperm into the egg

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14
Q

discuss a diagnosis of infertility as a life crisis

A
  • salient feelings of loss of control
  • desire for a child & life plan is thwarted
  • challenges to relationship
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15
Q

discuss the impact of infertility on individuals

A
  • self-esteem
  • sexuality
  • emotional state
  • stigmatised identity - isolation/social networks
  • general health & wellbeing - physical demands & side effects of drugs
  • moderated by pre-existing emotional problems & individual differences*
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16
Q

discuss the impact on self-esteem for men

A

men are supposed to be manly

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17
Q

what can infertility be conceptualised as?

A

a chronic disease/chronic health problem

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18
Q

in regards to health & wellbeing, what is longterm infertility associated with

A
  • associated with lower quality of life & wellbeing for men & women
  • depression & anxiety elevated, more health complaints
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19
Q

discuss the impact of infertility treatment on lifestyle

A
  • economic costs
  • impact on career, women may put careers on hold, men may need to alter schedules
  • process & practical demands
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20
Q

can the treatment process be addictive

A

yes

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21
Q

discuss the relationship stressors that infertility can have

A
  • women “cover” for partners
  • sexual difficulties - performance pressure
  • emotional intensity of experience of infertility is unequal?
  • disagreement regarding treatment
  • using donor gametes may be threatening
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22
Q

what were some of the problems predicted with the rise of ART by ‘Life: 1969 Science and Sex’

A
  • removing biological foundations of morality
  • diff meanings of decoupling sex, love, procreations
  • end of institutions of marriage, family
  • virgin births may be common
  • mothers unable to love children they haven’t carried
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23
Q

what is the clinical anecdote associated with IVF parents

A

“highly anxious, perfectionist parents” - evidence doesn’t support

24
Q

what are some hypotheses regarding parenting after conception through ART

A
  • depleted psychologically
  • unrealistic expectations, vulnerable to depression
  • overprotective, intrusive parenting
  • devoted, highly motivated parents, optimal parenting
25
Q

discuss what the studies found on IVF and non-IVF mother’s adjustment to pregnancy

A
  • IVF mothers reported higher anxiety regarding outcome of pregnancy
  • differences in fetal attachment: shown mothers conceiving through IVF have a more intense attachment, less intense because of anxiety & no difference
26
Q

what overall did they find about pregnancy re qualitative/quantitative measures

A

no differences in quantitative measures b/w IVF pregnancies & normal, but there are qualitative differences

27
Q

discuss qualitative differences in IVF & normal pregnancies

A
  • coping strategies mean very different path to parenthood
  • IVF mothers are less likely to prepare a nursery
  • afraid to speculate about baby
  • less likely to attend antenatal classes
  • kept pregnancy secret for longer
28
Q

discuss the significant differences IVF mothers have in comparison to normal in their adjustment to parenting at 4 & 12 mths

A
  • lower self-esteem for IVF mothers
  • more concerns about child’s behaviour but this has changed (better temperament)
  • thought their children were more vulnerable at 12 mths
  • tendency to view child as ‘special’ 12 mths
29
Q

what were there no differences in at age 4 & 12 mths of IVF parents & normal

A

-mood state, competence, work patterns

30
Q

when investigating the difference between IVF and non-IVF mothers parent-child relationship what were the observational methods used

A
  • still-face procedure
  • strange situation procedure
  • emotional availability during free play
31
Q

what were the differences found in parent-child relationship between IVF at 4 & 12 mths

A
  • no differences between observed sensitivity, security of attachment, maternal sensitivity or child responsiveness at 12 months,
  • no differences more difficult child behaviour
32
Q

discuss differences found in parent-child relationship for IVF & non-IVF at child 5 years

A
  • no differences in mood state, marital adjustment, child behaviour problems
  • IVF parents report lower parenting stress than comparison older first-time parents
33
Q

discuss some conclusions from the reviews on parents

A

IVF parents:

  • lower self-esteem, self-efficacy early on
  • more likely to seek help with early parenting
  • more protective - child viewed as more vulnerable, less child autonomy
34
Q

discuss some conclusions from reviews on child neurodevelopment

A

epidemiological
studies:
- increased relative birth defects
-multiple birth more common, perinatal risks
-epigenetics
neurodevelopmental outcomes:
-not associated with cerebral palsy
-are associated with higher preterm birth & multibirth (and those are related to increase handicap)
-not associated with neurodevelopmental disorders

35
Q

what did they find regarding longer-term outcomes of young adults conceived by ART compared with not

A

n = 659, young adults aged 18-29 years who were conceived by ART had similar quality of life BMI & pubertal development to non-ART children
-self-report only

36
Q

ART women are ___ times more likely to have a ____

A

1.5 times more likely to have a preterm birth

37
Q

what percentage of ART births are pre-term compared to non ART

A 
10% = ART
6.8% = non-ART
38
Q

ART mothers are…

A

older, more socio–economically advantaged & less likely to smoke
-more likely to have hyper-tension & complications during pregnancy

39
Q

discuss some issues for children conceived with donor gametes in heterosexual families & same-sex couples - Golombok et al.

A

-impact of secrecy (child not told father is not father etc.)
-no genetic link b/w father & child
-“genealogical bewilderment”
same sex couples:
-absence of male or female role model
-stigma

40
Q

what did Golombok et al. find

A
  • DI & IVF parents showed greater warmth & emotional involvement with children at 4 & 11 mths
  • no differences re fathering problems
  • no differences re marital problems or child adjustment
  • BUT none had told the children about their origins at middle childhood & only 2 by adolescence
41
Q

when Golombok et al. studied 4 groups of children (natural conceiving, ED, DI & surrogacy) what did she find regarding the children

A

-no differences overall compared with SC children

42
Q

what did golombok et al. find regarding children produced by a surrogate, what does it suggest

A
  • children born through surrogacy had more difficulties aged 7
  • suggests that lack of gestational link may be more problematic than lack of genetic
43
Q

what are the research findings in general about lesbian parenting

A
  • consistent evidence mothers in fatherless families expressed greater warmth & interacted more with children
  • no differences in child emotional/behaviour or gender role development
  • lesbian co-mothers more involved than typical fathers
  • some evidence for positive psychological development
  • generally no better no worse
44
Q

what was found about the differences between lesbian families created through DI than heterosexual families

A

-less secrecy than heterosexual couples

45
Q

discuss gay men choosing parenthood generally

A
  • its a growing phenomenon
  • usually involved an egg donor and gestational carrier: often international
  • most are in committed relationships and have thought a great deal about it
  • most have supportive families
  • more research needed
46
Q

what are donor issues

A
  • child’s right to know genetic origins
  • implications of commercial egg & sperm donation
  • potential exploitation of surrogate mothers
  • reproductive tourism
47
Q

how many frozen embryos were in storage in 2011 in Aus

A

> 120,000

48
Q

what are the factors influencing decision making of what to do with remaining frozen embryos

A
  • success or failure in meeting reproductive goals
  • fears and fantasies about donation of genetic offspring
  • altruism
49
Q

what did the research find regarding remaining frozen embryos

A

-many opt to put decision off as long as possible
->90% think of embryos as potential child & potential sibling of existing children
<10% intend to donate to research or other couples

50
Q

discuss the percentages found regarding conditional donation

A
  • 4% indicated they would donate to other couples
  • 48% thought donors should be able to specify characteristics of recipients
  • 41% indicated they would be more likely to donate if donation was conditional
51
Q

What is the most common reason women are having babies later

A

had to wait to find a partner who wanted to commit to having a baby as well

52
Q

what did the big study (n=592) regarding older women’s pregnancy find

A
  • less pregnancy and anxiety symptoms

- lower fetal attachment

53
Q

what did the big study (n=592) regarding older women’s pregnancy find was more important than age

A

-personality (hardiness) and context factors

54
Q

what was associated with more complex pregnancy adjustment regardless of age

A

ART conception

55
Q

what did the big study (n=592) regarding postpartum adjustment for older women find

A
  • adjustment generally better
  • maturity associated with more positive experience of motherhood
  • no evidence of increased PND for older mothers
56
Q

what did the big study find for mothers conceiving through ART and postnatal depression/child’s temperament

A
  • no evidence of increased PND for mothers who conceived through ART
  • ART mothers report less difficult temperament

Applied Child Psychology (4 decks)

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