Why doctor – You specialize in the care of people facing infertility. Why this choice ?
Déborah Schouhmann-Antonio – It has actually been twelve years since I trained in this problem, because I myself followed a long course of PMA. This gives me a common term with the couples I meet, because I don’t conceptualize the subject, I know it.
What is usually the trigger that drives infertile people to consult you?
Most of the time, during the first interview, people tell me that they no longer recognize themselves since they were confronted with infertility, and that they do not like what they have become.
What emotions can cause difficulties in having a child?
Not succeeding in having a child naturally is a real test of life, which generates many negative feelings: anger, annoyance, tightness, failure, despair, envy, shame, guilt, jealousy, sadness, isolation, feeling of injustice, rumination , low self-esteem and self-confidence…
You often mention “the PMA syndrome”. Can you explain to us what it is?
I’m talking regarding the “PMA syndrome” when the baby project begins to encroach on your whole life: professional development, vacations, outings with friends, etc. What was very pleasant at first becomes obsessive.
Can infertility lead to the development of more serious psychiatric problems, such as depression or an anxiety disorder?
Yes, especially in fragile people, who have already had depression for example. Sometimes I send patients to the psychiatrist.
How hard is infertility to live with for the couple?
Often, the pressure put by the friendly or family entourage around parenthood is difficult to live with for a couple who cannot conceive naturally. It’s also sometimes complicated to see people of the same age having children when you can’t.
Then, medical procedures generally have an impact on sexuality, because couples in assisted reproduction tend to abandon recreational lovemaking, which drives people away. Infertility can also create conflicts, because the two members of the couple do not necessarily evolve at the same pace or do not accept the same things.
Generally, already fragile couples do not resist this kind of difficulty. On the other hand, there are couples that adversity ultimately strengthens.
And for women?
Concerning women in particular, many do not support the impact of hormonal treatments on their body, because they leave traces and sometimes make you fat or swell. They also suffer from the idea anchored in our society “that one is not a full-fledged woman if one is not a mother”, which is completely false of course.
And for men?
Men whose sperm is not qualitative often have the impression that it calls into question their virility. In addition, many feel guilty, because it is the women who follow the treatments, which are generally heavy to bear physically and psychologically.
Have you noticed, during your 12 years of practice, changes in your consultations?
Already, more and more people are consulting me. Then, they no longer necessarily come at the end of the race but sometimes before embarking on a course in PMA, to assess whether they really want to enter it, which is new. I also receive more and more infertile men and people who are wondering regarding sperm or egg donation. Finally, many patients are now referred to me by doctors, which was not necessarily obvious when I started working in this field.
Precisely, do you think that psychological help should systematically be offered in assisted reproduction courses?
Yes, that would be a good thing. Afterwards, everyone is free to consult or not.
What advice do you have for people dealing with infertility?
I advise them first to consult several specialists, because having different opinions helps to make the right decision. When I say “good decision”, I mean a decision in agreement with oneself and with one’s partner. This is very important, because beyond adults, it is the future of the unborn child that is at stake: regretting an oocyte donation, for example, can have disastrous consequences in the development of a whole -small.
Regarding people in a relationship, I also advise them to try to communicate as much as possible with each other, even if things are sometimes not easy to say. Many couples also lie to those around them regarding their problems, which I think is not bearable in the long run.
Finally, I invite you to be indulgent towards yourself, that is to say, to allow yourself to be in difficulty, to be unhappy, to express your despair, to show your weakness. It’s difficult, because we are in a society where social networks convey only positive things and perfect lives.
A last word on those who do not manage to have children, despite all their efforts?
We tend to forget them and only remember the good stories. However, there are people who, despite all their efforts, do not succeed, and my job is also to prepare them for this option. It’s not easy, because the desire for parenthood diminishes over time, but never really disappears: unfortunately it’s not a button that you turn on or off! But it is possible to live happily without children, especially if you have gone to the end of everything you might do, without exceeding your limits.
