الفهرس 
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Abstract
Motherhood is a central aspect of women’s identity, providing a major context in which women live & through which they relate to others . Infertility is more than a medical condition for which medical treatment is necessarily the most appropriate solution. Fertility problems cause women to question their identity and threaten their sense of themselves in ways which may contiue to have an impact even if their fertility problems are overcome and they become mothers (Guidice, 1998).Women’s adjustments to infertility are excerbated by the almost entirely negative view of infertility and infertile females underlying many medical, psychological and feeminist analyses. Women find infertility painful and feel themselves marginalized (Stodland, 2002). At times they concur with the negative views of themselves as desperate or psychologically inadequate, preoccupied with their desire to become mothers and eager to grasp any solution , however oppressive or unlikely to lead to success(Eugster et al., 2004).
Actually, a crisis of infertility is a difficult emotional experience since it has an impact on various aspects of marital and individual life such as social relationships, life objectives, quality of life, and sexual relations(Spector, 2004).
In fact, the psychological problems most commonly investigated are anxiety and depression; anxiety because of the stressful nature of the treatment procedures and fear that treatment might fail ; and depression because of the patients’ inability to conceive . Although most studies were performed in the western world (Reed & Van Horn, 2001; Chen et al., 2004 andMonga et al., 2004), contemporary studies show similar psychological findingsfor infertile females from Eastern world (Nasseri, 2000; Guz et al., 2003; Matsubayashi et al., 2004). All studies indicate that infertile women have high emotional distress levels as well as anxiety and depression. However a scientific explanation of the origins for anxiety and depression in infertile women remains obscure.
This thesis was designed aiming at covering the following area in theoretical part : (1) An overview on the stress and its impact, (2) An overview on the medical aspect of infertility, (3) Review the relation between stress and infertility, and (4) Review the related psychiatric aspects of infertility.
The practical part aimed at:
1) Find- out the relation between stress and infertility and vice versa among infertile females .
2) Assess the possible psychiatric problems in infertile females with comparison between women with explained, unexplained infertility and fertile ones .
3) Study whether there is healthy copying with stress or not.
4) Identify variables influencing psychiatric morbidity of infertile women.
5) Assess marital satisfaction among the infertile females.
The present investigations evaluated collectively forty women they were organized into two major groups, patient group which consisted of 15 women of explained infertility and 15 women of unexplained infertility attending Benha University Hospital and private infertility clinics in Benhacity who are receiving treatment for infertility, and control group which consisted of 10 cross matched controls.
We obtained an informed consent and inclusion criteria were insured before the study which included being Egyptian female patient fulfilling the diagnosis of female factor infertility, in the child bearing period, with neither male factor infertility nor history of major general medical diseases.
The tools were carefully selected to serve for the purpose of the study,this included(1)A semi-structured interview(clinical psychiatric assessment), (2) Marital Satisfaction Inventoryand (3) Stressful life events coping psychometry.
The study proper was preceded by a pilot study to identify any problems that can face the study proper, determine the size of the sample, identify the suitability of the tools used and assess reliability of clinical diagnosis.The study proper was performed in the period from Augest 2011 till February 2012.
All data gathered were recorded, tabulated and transferred on statistical package for social science using personal computer and the suitable statistical parameters were used. Results were displayed to answer questions raised in the hypothesis of this study.
The first important group of results aimed at estimation of psychiatric morbidity among infertile females with comparison between women with explained, unexplained infertility and fertile ones regarding details of diagnosable psychiatric disorders. This was done through evaluation of psychiatric morbidity among infertile females (Axis I and Axis II diagnosis).
*6.7% among explained infertility females had positive family history of psychiatric disorder in comparison to none of unexplained infertility females and control fertile females which was statistically insignificant.
*Regarding the past history of psychiatric disorder in infertile females, there was statistically insignificant difference between explained ,unexplained infertility females in comparison to control fertile females.
*PMDD was by far the most encountered past diagnostic category among infertile ladies followed by social phobia .
*40%, 46.7% of the explained and unexplained infertlity groups respectively fulfilled the diagnostic criteria of PMDD in comparison to none of the controls which was staistically significant.
*Psychiatric diagnosis at time of interview was of statistically significance in both the explained and unexplained infertlity groupsin comparison to the controls.
*Anxiety diorders were the most frequent encountered diagnostic category in the explained and unexplained infertlity groups reaching (60%, 73.3%) respectivelywhile reaching only 20% in the controls.
*Followed by mood disorders (60%,53.3%) inexplained and unexplained infertlity groups in comparison to 10%in the controls.
*Then somatization disorder was (40%,26.7%)inexplained and unexplained infertlity groups in comparison to none of the controls but was statistically insignificant.
*Comorbidity between mood and anxiety disorders was high (40%, 53.3%)inexplained and unexplained infertlity groups respectively.
*Infertile ladies showed that 67.7% of eitherexplained and unexplained infertlity groups had personality disorders compared to 50% of the controls which was statistically insignificant.
*The most frequently encountered categorical Axis II diagnosis among infertility groups were paranoid, obssessive, depressive and avoidant personality disorders.
*Bad early and late home atmosphere were of significant difference among the infertile groups in comarison to the fertile ones.
* Regarding sexual history, there was statistical significant difference between infertile and fertile ladies regarding bad idea about sex, sexual dissatisfaction and painful intercourse.
*On Stressful life events coping psychometry, it’s obvious that 40% of the explained infertility group and 66.7%of the unexplained infertility group had bad coping to stress in comparison to only 10% of fertile ones which was statistically significant.
*On applying the Marital Satisfaction Inventory, infertile females showed significant difference regarding CNV,GDS, AFC, TTO, FIN, SEX and FAM subscales when compared to fertile females.
The second group of results aimed at identifying variables influencing psychiatric morbidity of the infertile females, we were concerned by socio-demographic variables, infertility history, personality profile, coping to stress and marital satifaction.
As we compared infertile women with psychiatric morbidity by those who had no psychiatric morbidity, data revealed that:
*Age, occupation, work hours per day, holidays, financial state and marital duration had statistical insignificant relation to psychiatric morbidity.
*Majority of infertile patients with psychiatric morbidity(54.5%) had past history of PMDD which was statistically significant.
*Positive family history of psychiatric disorders had insignificant difference when related to psychiatric morbidity among infertile females.
*Infertile patients due to tubal, uterine and unknown cause are more likely to have psychiatric morbidity .
*Personality diorders had statistical insignificant relation to psychiatric morbidity among infertile females.
*Infertile females with psychiatric morbidity were more liable to had bad coping to stress with statistical significance.
*Marital satisfaction among infertile females had statistical insignificant relation to psychiatric morbidity.