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Case D: Couple with male factor infertility
Mrs. and Mr. D, she 37 yrs old, he 40 yrs, desire for a child and in treatment since five yrs. His diagnosis: Kallmann Syndrome. Since five yrs testosterone replacement therapy (hormone injections every two weeks).
The couple has undertaken 13 „fresh“ ICSI cycles (because she is a „low responder“) in three fertility clinics in Germany and Austria. She has had a miscarriage after cycle 6 two yrs ago.
He wants to stop treatment with hormone injections, she wants to proceed with ART in Spain because of the reported
high success rates.
(© Wischmann 2019)
Heidelberg University Hospital | ESHRE PCC 8 Vienna (Austria) 23 June 2019 | Prof. Dr. Tewes Wischmann | 21
Helpful couple counselling strategies (I)
"Feeling guilty" is not the same as "being guilty"
Identify allocation of blame on man and replace it with "accepting
my part of the responsibility for our common problem“
Change attribution errors and unfavourable coping styles
Change man‘s internal attribution ("I‘m a failure") to external attribution ("This blow of fate is our challenge")
Strengthen active and meaning based coping styles, replace
passive and avoidance coping styles
(Van den Broeck et al. 2010)
(Petok 2006)
Heidelberg University Hospital | ESHRE PCC 8 Vienna (Austria) 23 June 2019 | Prof. Dr. Tewes Wischmann | 22
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