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Psychoanalytic Understanding of Repeated In-Vitro Fertilization Trials, Failures, and Repetition Compulsion

Mali Mann

Rapid advances in reproductive technologies confront us with the need to understand the complex psychological impact on participating parties. Understanding of repetition compulsion and psychoanalytic understanding of repeated IVF trials and failures is an important dynamic in some of the patients who resort to these methods. The discussion of two detailed case histories, illustrate how infertility traumata were re-experienced compulsively during the course of treatment. The unconscious self-induced traumatization resulted from the compulsion to repeat an earlier repressed trauma. The denial of multiple and repeated failures illustrate a complex compilation of several unprocessed losses that the individuals have yet to finish mourning. In addition, the lack of acceptance of a failure to conceive presented itself as a technical challenge offering an understanding of repeated past experiences in the context of the transference and counter transference paradigm. Each new IVF cycle followed the unprocessed mourning of a loss with persistence to repeat. The repeating of the past experiences over and over in a rather fast-paced use of ARTs shows the strong evidence for dynamic repetition compulsion phenomena. The denial of the failure to conceive can linger on, becoming a long process with unfinished mourning throughout the life cycle. There is a need for psychoanalytic thinking and understanding of psychological implications of the use of In-Vitro Fertilization (IVF).