Qualitative Evaluation of Psychological Challenges in Infertile Females Undergoing Alternative Infertility Treatment Methods

Infertility is among the issues with multiple effects on couples' lives. By the development of medical science and the use of new methods of infertility treatment, including embryo donation, sperm donation, egg, and surrogate uterus donation, these problems have been largely solved; however, any advancement in technology and medicine also brings challenges. Sometimes these challenges are also problematic and take precedence over the essence of the problem. Applying advanced assisted reproductive techniques, such as using third–party gametes and surrogates, increased the expectation of pregnancy in couples without children despite numerous surgical and pharmacological interventions. Alternative methods of treating infertility or third–party infertility refer to the use of an egg, sperm, or embryo donated by a third party and obtaining another uterus to develop the fetus. The present study aimed to explain the psychological challenges of infertile women who intend to have children through alternative methods of infertility treatment.

This was a qualitative study with an interpretive phenomenological design. The study participants included a group of women with infertility. Accordingly, 10 infertile subjects were referred to one of the infertility treatment clinics in Mashhad City, Iran, and applied for one of the new methods of assisted reproduction, including egg donation embryo or surrogate donation. Now the beginning of the end of the treatment was selected using the purposive and criterion sampling methods. The required data were collected using in–depth and semi–structured individual interviews. The interviews lasted an average of 45 minutes, beginning with the key question, "Which alternative method did you and your spouse most agree to use, and what challenges did this agreement pose to you?" Follow–up questions were probed according to the previous answers and more specialized. The obtained data were coded and analyzed by DiKelman et al.'s (1989) method. The coding process was analyzed in the form of primary codes, concepts, and categories. In this study, MAXQDA was used to analyze the collected data.

The study results led to the extraction of 248 initial codes of 7 concepts and 3 categories; they reflected the psychological challenges perceived by this group in the path of new assisted reproductive therapies. The study findings were extracted from the description of psychological challenges by infertile women; they were divided into 3 general categories based on the scope of these challenges, i.e., as follows: 1– focal challenges (i.e., challenges related to the treatment process, mental and emotional challenges of couples, challenges related to marital relationships and challenges concerning the child and the role of being a parent). Infertility as a defect and the treatment that couples choose and seek to compensate for that defect in themselves or their spouse poses a series of challenges for them, both individually and in the relationship with their spouse. The scope of these challenges included the individual and their spouse separately and concerning each other. The scope included all thoughts, feelings, thoughts, and ideas and biopsychosocial, religious, and economic issues of the person and his wife separately; also concerning their life together. 2. Local challenges (i.e., challenges related to family acceptance and challenges related to the reaction of families & others) include psychological challenges that go beyond the focal challenges, that is, beyond the boundaries of the individual and the couple. It consists of family, friends, and society. They became a family and a community which surrounded them. It includes the individual and the couple's concerns concerning family, friends, neighbors, and the community. 3. Extensive challenges (i.e., sociocultural & religious issues). These challenges included psychological issues and challenges that were broader than the local and local challenges and factors and were influenced by society's beliefs, culture, and general policies.

Alternative therapies for infertile couples have numerous challenges that stress the individual and his family. Therefore, to improve the quality of life of infertile couples and the intensive care of the treatment process, a program should be developed and implemented to diagnose, find the cause, and solve these psychological problems and psychological pressures.