Reflections on the psychodynamic approach to female sterility

The authors examine psychodynamic factors related to infertility. They reject the distinction between organic and psychogenic infertility. They point out the importance of the maternal image and identification, the Weight of unresolved conflicts, and fantasies of mastering one's own body. The action of corporal narcissistic vulnerability of trans- and intergenerational charges is also underlined. A clinical illustration shows the hypothesis defended from accumulated factors that invalidate the procreation wish so that it becomes impossible for the women to mentally develop these conflicts. The authors discuss therapeutic options and the risk of finding no solution. They propose a clinical and ethical position to accompany these infertile women. They try to consider particularities of their intrapsychic operations, the nature of their request, the help offered to them and finally their possibility of reaching a sense of personal accomplishment without procreation. (C) 2001 Editions scientifiques et medicales Elsevier SAS.