Not pregnant yet? You bet!. Rimma Efimkina

children could be tied to the fact that on subconscious level he does not want to undertake any obligations and responsibility for a child8. I agree with this statement, still, I think there are other reasons, but I haven’t got a chance to exercise my knowledge – as I have mentioned, no man ever addressed me as a psychotherapist with an infertility problem. But women do address me on the subject of MALE infertility.

      I will unfold the underlying reasons using examples from my practice below. One of them is lack of a better choice. It is well-known that a person always chooses the best of currently available options. I would like to show other options and may be people would like to change their behaviors and their lives.

      Women who love too much

      I love humans

      I love animals

      I love neighbors

      I love hobos

      I love doing laundry

      I love vacuuming

      Give me more of those pills.

Internet meme

      Here is a typical dialogue from babyblog.ru Internet forum9:

      Olunja: Hi! I’m perfectly healthy, our problem is male factor… I had two inseminations10… Didn’t work… I didn’t take ANYTHING prior to the insemination, but 36 hours before hand they gave me a shot of PREGNIL. Ouch! It hurt so much!!!!! Then the inseminations… A week later ONE MORE TRY: a shot of PREGNIL to get things going and no more shots after this. Just UTROGESTAL in the form of suppositories daily for a long-long time. Then I lost all hope… Was depressed… I’m bit better now and here we are – doing IVF… Do you make the shots all by yourself? Does it hurt?

      Katisha: My mother-in-law does. Did you think the shot hurt? I don’t feel any pain from the shot itself, but my breasts hurt. I do hope AI [artificial insemination] helps, otherwise I’ll have to have laparo11, and then pills, shots… waiting… I don’t want IVF so much. Cheer up, Olunja, our IVF girls go around so happy. You will be fine and it will work for sure!

      Olunja: I wish somebody gave me the shots… I have to do this myself. I make them at 9 p.m…. I live in the countryside… Before the first insemination one woman-doctor prescribed 5 pills of something (I don’t remember what it was) which caused OVERstimulation. We had to wait for the first insemination for two more months. I changed my doctor and I’m happy now. And before the insemination the nurse gave me THAT hurtful shot. My hip burnt…

      I didn’t want hysterosalpingography12 either – but I had to…

      And I didn’t want laparo – but I had to…

      And in BOTH cases EVERYTHING WAS FINE! No problems!.. But still no kids. So my last hope is IVF.

      Katisha: Oh, Olunja, I get you. My tests are fine, except for hormones (hystero, HSG, but no lapro), got my ovul [ovulation] induced, I have O for two months now, but no P. That’s why I had AI, so that the spermies got there for sure. So you are having IFV with ICSI13?

      The women of this society have their own slang: ovul, spermies, laparo, hystero. Some words were reduced to one letter: O (ovulation), P (pregnancy), MM (missed miscarriage) – they have to use them so often, one letter is enough to understand what they mean. It’s all fine, a typical conversation, but one thing caught my attention and bothers me from the very beginning: “I’m perfectly healthy, our problem is male factor”. So, does this mean Olunja deals with all these interventions – both surgical and hormonal (and, as it turns out, futile) – for the sake of her husband? And do all the forum readers perceive this so-to-say “treatment” of a healthy person as a norm?

      I am shocked. I re-read the contradictions for medical procedures for infertility mentioned above. They include mental disorders, congenital development issues, tumors, acute inflammatory diseases, malignancies. However, I did not find only one contradiction – the woman being healthy. Is it not contradictory to offer damaging procedures to a healthy woman? Isn’t this the man who should be treated if he has problems preventing him from becoming a farther?

      Medical specialist would object that today’s medicine does not have any effective ways of treating infertile men. Why do you think this is? Maybe because men are not so dependable and controllable as women are to be experimented on in such a way? Maybe the world-wide-spread discrimination of women reveals itself on this level as well? And maybe it’s high time women came to think of this: if it does not work with this partner, maybe their relationships are the reason? And this is the subject of relationships psychology, where medicine treating people as soulless bodies is powerless. This is why, Olunja, neither insemination, nor hysterosalpingography, nor laparoscopy bring any results.

      But let’s go back to the “male factor”. I repeatedly spoke to healthy women whose husbands were incapable of fertilizing. One of my psychotherapy group members liked to sigh over the fact how she just loved children, but when I asked her directly why didn’t she have any, she got embarrassed and didn’t say a word. She came to me during a brake and whispered to my ear: “My husband just can’t…” I knew that she was filthy rich, but she didn’t not work. So I suggested that she is kept by his side not only by emotional, but also by financial ties and fear to step outside her comfort zone.

      The other participant of my psychosomatic workshop, whose hair fell out after IVF procedure, said bitterly that she did not to go through with it for the fifth time, because after the forthcoming procedure there was a greater risk of cancer. I asked her why she even discusses the possibility of yet another try, she said that otherwise she would have a conflict with her husband who cannot fertilize her in an ordinary way because of his low sperm motility. Her husband insisted on having a baby, and she was afraid that if she refused to go through the dangerous and damaging procedure, he would leave her.

      Bert Hellinger thinks that if one partner is physically unable to have children he does not have a right to keep their partner at their side. If they do stay, the other one should treat this decision exceptionally respectfully. This is very important. It is only in this case that everything is clear and consolidated between them14. I fully agree with him. Respect instead of threats, willing consent instead of fear – do you feel the difference?

      Unfortunately, women often do not realize they fear their husbands, because they mistake their fear for love. But love lives where there is order, and to make this happen partners should discuss the details of the situation they are in, share their feelings. Women more often obey the decisions their husbands take on an ex parte basis. Psychologists call this widely spread fear of one’s husband “love addiction”. It is easily mistaken for love, and that’s sad, because instead of treating the love addiction with psychotherapy, women treat the supposed infertility with surgery.

      There is a story of a woman who was afraid to say no to her husband below.

      “Kittens”15

      I will take you to the North,

      Sparkling snow back and forth

      Gigantic stars – a wonder each.

      And I will go to the beach.

Internet meme by Alex Dedyaev

      When

8

Ruediger Dahlke, The Healing Power of Illness: Understanding What Symptoms Are Telling You.

9

http://www.babyblog.ru/community/post/sterility/410091

10

Insemination is the deliberate introduction of sperm into a female animal or plant for the purpose of impregnating or fertilizing the female for sexual reproduction.

11

Laparoscopy, see above.

12

Hysterosalpingography (HSG), also known as uterosalpingography, is a radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the fallopian tubes.

13

Intracytoplasmic sperm injection (ICSI) is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used in order to prepare the gametes for obtaining of embryos that may be transferred to a maternal uterus.

14

Bert Hellinger, The Art and Practice of Family Constellations.

15

This case was kindly provided for my book by my daughter and psychologist Anna Efimkina with the permission of the client Yana (the name is changed).