Infertility is both a psychological and physical problem faced by many couples all over the world. There are at least 60 to 80 million people who suffer from infertility worldwide, and this number could be higher because many people do not report their infertility or seek help. (Cassidy & Sitrovani, 2008) The National Survey of Family Growth defines infertility as the inability to conceive after at least 12 consecutive months of unprotected sex. (Kessler, Craig, Plosker, Reed, & Quinn, 2013) Many people try for years to have their own children and are unsuccessful, leading to many psychological problems due to both infertility and treatment options. There are a number of reasons why men and women cannot have children. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an original essay Although there are many biological factors that attribute to infertility, the most limiting of these reasons seems to be an increase in childbearing age, as this cannot be reversed despite all the advancements in treatment options. Many couples and women choose to postpone having children to pursue a career and a more stable financial situation. This could be a potentially detrimental decision for a couple trying to conceive, as women reach their greatest fertility in their early to mid-twenties and this declines steadily with age and for men it becomes increasingly more difficult to have children when they reach their mid-30s and beyond. (Kessler et al., 2013) Beyond advanced parental age, there are an almost overwhelming number of biological reasons why a couple is unable to have a child. Women may have a blockage or abnormality in the fallopian tube from endometriosis or STIs that have left scar tissue. Pelvic inflammatory disease could also be a cause. When there is a blockage in the fallopian tubes that could prevent sperm from reaching the egg or allow an egg to reach the uterus even if the sperm successfully reached the egg and fertilized it. The problem could also lie in the ovaries themselves or in the woman's ovulation. These can be caused by an imbalance in a woman's hormones, growths, problems related to a woman's body weight being too high or too low, cysts in the ovaries, or any other problem. (Herdt & Petit, 2014) Men also suffer from infertility due to problems including, but not limited to, low sperm count, poor sperm movement, or even malformed sperm. The reasons for this are endless and can be biological or environmental. (Herdt & Petit, 2014) Infertility is seen as a life crisis with profound psychosocial impacts. (Onat and Beji, 2012) When a person suffers from infertility or is told that they cannot have children naturally, they experience symptoms usually associated with a significant loss. Many people reacted to an infertility diagnosis as if it were a disaster. (Waltzer, 1982) In a study of 200 couples at a fertility clinic, it was shown that 50% of women and 15% of men reported that infertility was the most upsetting experience of their lives. ("The psychological", 2009) These symptoms include, but are not limited to, stress, anger, depression, anxiety, problems withwithin the marriage and feelings of uselessness, incompetence and even defectiveness. Couples or individual partners also experience a sense of loss and lower self-esteem. (Deka and Sarma, 2010) When someone is told they are infertile, they are technically grieving the loss of the children they thought they could have, which has a significant impact on their emotions and mental health. A study carried out in Sweden found that three major factors play a role in this psychological stress: "having children is a major life goal", "the female role and social pressure" and "the effect on sex life ". (Deka & Sarma, 2010) When a couple discovers that they cannot have a child, they experience lower levels of satisfaction in their sex lives. (Lykeridou, Gourounti, Deltsidou, Loutradis, & Vaslamatzis, 2009) These difficulties in their sex lives can be attributed to a number of different things, including blaming their partner for infertility, blaming themselves, or even to be anxious. (“The Psychological”, 2009) In some cases, the infertile spouse considers leaving their partner because they are unable to give them a child. (Onat & Beji, 2012) If a couple turns out to be completely infertile, they report feeling isolated because unlike other people, they cannot have genetic children, angry at having no control over their own body. Infertility causes a lot of stress when couples or individuals realize the high cost associated with treatment. More than 40 percent of couples who seek help for infertility never complete their treatment. If a person cannot afford treatment, or if their insurance does not cover treatment or if they cannot hire a surrogate or bear the financial burden of adoption, they will have to grieve the loss of the child and she will lose all hope of ever having a child, which can be emotionally crippling. (Kessler et al., 2013)Social pressure to have a child is everywhere. Once a couple is married, people wonder when they will start having children and don't really think about whether a couple is physically capable of having children. Couples reported being pressured, excluded and poorly treated by their families because they did not have children. (Onat & Beji, 2012) In one study, a couple reported avoiding being in places with children so as not to have to deal with issues related to their own childbearing. Societal pressure to have children is so strong that couples isolate themselves from it. (Onat and Beji, 2012) If a couple suffers from infertility, they may avoid social interactions with friends or family members who already have their own children or who are pregnant. ("The Psychological", 2009) Not only is there pressure on couples, but also many cultures expect women to have children and there seems to be a stereotype that this is not the case in the United States, but in reality the pressure on women to conceive still exists. American culture stigmatizes a childless woman as a “real woman,” deviant, abnormal and sometimes even selfish. Not only should these women reproduce, but they should also want to reproduce, because it is their “social duty”. (Cassidy & Sintrovani, 2008) In the past, if a couple was found to be infertile, the only option for having children was adoption, but a number of different techniques have been developed to help people in their efforts to have children . Couples may choose to have children through adoption, surrogacy, egg donors, in vitro fertilization, intra-fallopian gamete transfer,intra-fallopian zygote and artificial insemination either of the man trying to conceive or of a donor. Adoption is when the couple legally takes custody of a child with whom they usually have no genetic connection, a surrogate mother relies on a woman who is not part of the couple to carry the baby to term, give birth then hand it over to the couple to adopt. The baby may be conceived using donor sperm, an egg from a surrogate mother or another donor, or even with sperm and egg from one or both parts of the couple. In vitro fertilization involves removing eggs from a woman's ovaries and fertilizing them with sperm in a laboratory dish, then implanting them directly back into the woman's uterus. Intrafallopian gamete transfer occurs when a doctor places a sperm and egg directly into a woman's fallopian tube. Intrafallopian zygote transfer occurs when an egg is fertilized in a laboratory dish and then that egg is placed directly into the fallopian tube. Artificial insemination occurs when sperm from a donor or partner is placed directly into the vagina or uterus when the woman is thought to be ovulating. (Herdt & Petit, 2014) Although all of these options have a chance of success, they come at a high financial and emotional cost and run the risk of failure. Many couples report that the cost of infertility treatments has caused financial problems. (Onat and Beji, 2012) Infertility treatments and options have a physical and psychological effect on women and men. Women report experiencing negative changes in their body during treatment, such as headaches or pain from injections. (Onat & Beji, 2012) A study in Greece showed that women undergoing infertility treatment experienced high levels of anxiety. (Lykeridou et al., 2009) Both members of the couple also feel more depressed and stressed. When a couple is stressed about treatment, it can actually become counterproductive and create an even greater challenge in getting pregnant. A depressed person is thought to have higher levels of prolactin, thyroid dysfunction, and a change in the immune system that could affect fertility. In depressed women, the hormone that regulates ovulation is thought to function abnormally when they are depressed. These psychological symptoms lead many people to stop receiving treatment. (Deka & Sarma, 2010) It has been shown that certain medications used in treatment can cause their own psychological side effects. For example, a medication normally prescribed to improve ovulation is suspected of causing anxiety, sleep disturbances, mood swings and irritability. Some other medications are thought to cause depression, irritability, difficulty thinking, and even mania in some patients. (“The Psychology,” 2009). Sex life is also believed to be affected by these drugs, and patients begin to view themselves as "fertilization machines." (Onat & Beji, 2012) Both the person undergoing treatment and the doctors themselves have difficulty determining which symptoms come from the stress of the treatment and which come from the medications. Not only can infertility treatments cause new psychological problems, they can also make existing conditions worse. (“The Psychological,” 2009) Patients experience these psychological symptoms very intensely while undergoing treatment. (Onat & Beji, 2012) A woman reportedly said: “Having yourmenstruation during treatment was a period of mourning. I felt really sad and disappointed. It's a terrible frustration. It takes away all your physical and psychological strength. (Onat & Beji, 2012) Women seem to experience more stress than men during both the diagnosis and treatment of infertility. (Deka & Sarma, 2010) For this reason, it is recommended that women undergoing treatment seek psychological support. (Lykeridou et al., 2009) Couples are offered many different treatment options, all of which carry their own negative and positive outcomes. Many couples attempt to adopt children, but experience growing dissatisfaction with the process due to the grueling nature of the selection process, concerns about laws, high costs, and small numbers. of children available for adoption, because the waiting list is very long. Doctors suggest that couples wishing to adopt should confront their grief issues related to their inability to have genetic children and any bitterness they feel toward their spouse because of infertility. It has been shown that when the adopted child reaches puberty, these feelings can resurface in the parents, leaving the father feeling threatened by his son's ability to procreate and the mother envious if her daughter is able to have her own genetic children. (Waltzer, 1982)Another option available to couples wishing to have children is artificial insemination, whether from the husband or a donor. Many parents prefer this method of creating children so that the mother can carry her own child and experience childbirth, there is a genetic connection between parents and children, it gives parents the ability to bond with the child. child even before birth. Donor insemination is also a way to deal with the social pressures of infertility, because most people, except the couple, are unaware that the father was incapable of carrying his own children. (Daniels, 1994) On the other hand, the husband in the relationship might feel that "the growing abdomen...may be a reminder...of his 'incapacity' and a rival father." Some women gain their spouse's approval through emotional blackmail, which can lead to complications. (Waltzer, 1982) It has been shown that many people who become parents through donor insemination tend not to tell their conceived children and never know that they are not genetically related to both parents because the parents fear that the child will not be born. able to bond with the non-genetic parent. It has been shown that keeping this secret can have a negative effect on the family. Many children have reported that they suspect something is wrong in their childhood and that if the child ever finds out that they are not genetically related to one of their parents, they become very curious about know their genetics and wants to know more about their biological parent. (Golombok, Murray, Brinsden, & Abdalla, 1999) Opinions vary as to whether or not parents disclosing their child's true genetic makeup has negative or positive effects on the child. Surrogacy is an option that some couples choose in order to be able to preserve genetics for others. relationship with their child or avoid the adoption process. It has been shown that the absence of pregnancy could alter the experience that parents have with the child before birth, and that if someone other than the couple is involved in the birth of a child, this could lead to parental difficulties. and even psychological problems for the child. (Golombok, MacCallum, Murray,.,” 2009)