MANAGEMENT OF INVOLUNTARY CHILDLESSNESS

Any definition of involuntary childlessness has to consider the differ ence between sterility and subfertility. As the latter affects about 2 0-30% of all couples at least once in their lives, general practitione rs (GPs) may be the first to be confronted with this problem. This rev iew presents the most relevant diagnostic and therapeutic options in c ases of female or male infertility, and discusses the new assisted rep roductive technologies (such as insemination, in vitro fertilization, gamete transfer and intracytoplasmatic sperm injection) so that GPs ma y adequately inform their patients about these procedures and their ri sks and outcomes. Although controversial, involuntary childlessness an d its clinical treatment seem to have a strong psychological impact on a couple's social, emotional and sexual life. Being available for dis cussion with childless couples and offering ongoing support may be the most important role for the GP in this context.