Infertility as Seen through the Lens of Uncertainty in Illness Theory

By Loretta Camarano and Nancy Smee.

Published by The International Journal of Interdisciplinary Social and Community Studies

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Article: Print $US10.00
Published online: April 9, 2014 $US5.00

Infertility affects approximately 10% to 20% of the childbearing age population worldwide. Since infertility strikes diverse groups, affecting people from all socioeconomic levels and cutting across all racial, ethnic and religious lines, it is a community health problem of significant import. Infertile women report that infertility is the worst crisis of their lives; experienced as more significant than divorce or the loss of a parent. Yet, it is a condition that is coped with largely in secret among couples and their health care providers. The inability to have children threatens the very essence of some people’s being and self-worth in their family and society settings. Most research on infertility has been based on theories of stress and coping, but has neglected the concept of uncertainty that has been shown to significantly affect the infertility experience. The purpose of this paper is to provide a theoretical context for the study of infertility, and to offer partial explanation for what may be driving advanced reproductive technology choices among infertile couples. Mishel’s Theory of Uncertainty in Illness as a functional theory that has been used across health care disciplines is applied to infertility. A conceptual model of the theory is presented, explained and critiqued for its usefulness in understanding the lived experience of infertility. There is need for further investigation into mechanisms to aid coping and adaptation surrounding the diagnosis of infertility. Understanding the role of uncertainty offers important implications for care providers, researchers and their infertile clients.

Keywords: Infertility, Uncertainty, Women, IVF, Assisted Reproductive Technologies

The International Journal of Interdisciplinary Social and Community Studies, Volume 8, Issue 1, April 2014, pp.51-65. Article: Print (Spiral Bound). Published online: April 9, 2014 (Article: Electronic (PDF File; 385.943KB)).

Dr. Loretta Camarano

Assistant Professor, School of Nursing, Samuel Merritt University, San Mateo, California, USA

Loretta Camarano has worked for many years as a nurse in the field of reproductive endocrinology and infertility. She received her PhD from the University of California, San Francisco. Her research examines factors that predict adverse perinatal and pediatric outcomes such as low birth weight, preterm delivery and autism in children conceived by women with a history of infertility and treatment with in-vitro fertilization. She is an assistant professor at Samuel Merritt University in San Mateo, California and is the Director of Quality, Education and Compliance at Fertility Physicians of Northern California.

Dr. Nancy Smee

Assistant Professor, School of Nursing, Samuel Merritt University, San Mateo, California, USA

Nancy Smee has worked for many years as a nurse-midwife and women’s health nurse practitioner. During her studies for the master's program in public healthat the University of California, Berkeley, she became interested in the vulnerability of women during the reproductive years. She received her PhD from the University of California, San Francisco, where she also completed a post-doctoral fellowship in the prevention and treatment of HIV and reproductive problems associated with HIV infection. Her ongoing research is centered on the sexual behaviors and reproductive choices of HIV-infected women. She is an assistant professor at Samuel Merritt University in San Mateo, California.