Life After Infertility: a Grounded Theory of Moving on From Unsuccessful Fertility Treatment

Despite the many advances of medical technology to help treat infertility, approximately half of women seeking fertility treatment will never give birth to a child. Women coping with treatment failure face many challenges, including deciding when to abandon treatment and how to let go of their dreams of having a baby to focus on other pursuits. In order to better understand how women cope with these challenges, in depth interviews and a focus group were carried out with 12 women for whom fertility treatment had not been successful. Data was gathered and analysed using Grounded Theory, and a model of the process of adjustment from pursuing treatment to coming to terms with involuntary childlessness was co-constructed from the data. The model conceptualizes women’s journey as moving through three main phases; ‘living in limbo’ in which women are still undergoing treatment, ‘leaving treatment’ in which women decide to terminate treatment and abandon the search for a resolution to their infertility, and finally ‘learning to live with involuntary childlessness’ in which women start the ‘work’ of grappling with the questions that childlessness seems to raise about the meaning of their lives, their identity and self image, and their sense of social belonging. The model goes on to highlight the factors which seem to aid women in resolving these challenges. The findings of this study suggest that the emotional challenges of coping with unsuccessful fertility treatment extend well beyond the end of treatment, highlighting the need for good access to therapeutic support for women coping with involuntary childlessness longer term. Results also point to certain sources and types of support which may be particularly helpful, including peer support from other childless women, and therapeutic interventions which help women develop more positive perspectives on childlessness and to identify alternative sources of fulfillment. The results of this study also point to the need for social action which works to challenge the misconceptions and stigma surrounding infertility and childlessness which add a further challenge to the lives of women who are involuntarily childless

Total parenteral nutrition associated cholestasis: A predisposing factor for sepsis in surgical neonates?

Of 496 neonates and infants less than 1 year of age admitted to the paediatric surgical intensive care unit (PSICU) over a 5 year period (1983-1987), 94 required total parenteral nutrition (TPN) for more than 14 consecutive days, generally due to congenital anomalies of the digestive tract. Cholestasis occurred in 15 of them and 12 of these patients developed sepsis. In contrast, of the 79 patients on TPN that remained free from cholestasis, only 23 developed sepsis. The mortality rate for the TPNAC-group was substantially higher than for the group without TPNAC. It is suggested that development of TPNAC might lead to impairment of non-specific cellular immunity in neonates

2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe