Sterility & Neurotics

When a woman goes to her doctor and complains that she doesn't seem to be able to have children, the doctor usually assumes that her trouble is physical and that he must do all in his power to help her achieve pregnancy. Not necessarily, says Chicago's Dr. William Saul Kroger: it may well be that the cause of the patient's sterility is psychological, and that it would be a bad thing for her to become a mother. In fact, he told the American Society for the Study of Sterility last week, this kind of sterility in neurotic women may be "nature's first line of defense against the union of potentially defective germ plasm."

Gynecologist Kroger (a hard-bitten bachelor of 45) sees physiological evidence to support this idea in the large number of miscarriages, toxemias and other complications of pregnancy and labor which often follow long-standing sterility of psychological origin.

Anything in the World? As for the mental mechanics of the problem, Dr. Kroger reports that many women "straddle the fence" in their attitude toward motherhood: behind the conscious desire to bear a child there may be a deeper, unconscious revulsion against having one. This, in turn, may be the result of emotional immaturity and dependence (seeking to make the marriage into a child-parent relationship with the husband as parent), or an aggressive, masculine personality which would make the patient resent a child's demands on her.

Several patients studied by Dr. Kroger were overweight, and he attributed their obesity and sterility to the same cause--a childlike desire to be taken care of. "We have often noted," said Dr. Kroger, "that these neurotic women state that they 'will do anything in the world to get pregnant,' yet when given diets and basal body temperature charts, they find many rationalizations for not dieting and keeping the monthly record." The last thing in the world that they really want, he contended, is weight reduction and the normal ovarian function which could make pregnancy possible.

A Hollow Triumph? Dr. Kroger did not suggest that because a physician considers a woman patient neurotic he should take upon himself the burden of deciding whether or not she should have a child. Instead, he proposed that the physician, perhaps with the help of a psychiatrist, explain to the patient the emotional meaning of her sterility, and thus help her decide for herself.

But in any case where sterility of mental origin is overcome by medical help, said Dr. Kroger, "the same psychological difficulties which once prevented conception may influence the child's psychic development, and just as in the case of the emotionally immature but fertile woman, another member is added to an endless procession of neurotics. Therefore, the physician must.be aware that apparently 'successful' treatments of [such] sterility without adequate psychotherapy may actually become a hollow triumph."

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