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Yesterday, a striking and self-possessed woman came into my office. Within minutes, she was in tears. Despite having two sons whom she adored and a high-powered career, she desperately wanted a third child. She had suffered painful miscarriages, multiple IVF attempts, and was now considering adoption, something her husband did not want. How many times would they try for a successful pregnancy before they gave up?
Later that day, I met with a lesbian couple. Each woman had borne one of the children. A mutual friend of the couple donated his sperm, so each child shared the same biological father but each had a different biological mother. The couple was trying to craft a birth story for their children and wanted to discuss how and when they would tell their children this story. What a timely book this is!
While the ethical and moral implications of artificial reproductive technology (hereafter referred to as ART) have been widely debated since the first “test tube” baby was successfully delivered in 1978, exploration of the psychological ramifications lags far behind.
Mali Mann edited the book and contributed two of its chapters. She selected four additional writers to illuminate not only the complex path to conception but also its psychological impacts. Each of these interventions, whether it be IVF, ICI, IUI, egg donor, sperm donor, surrogacy, or adoption require third parties thus disrupting the traditional mother/father/child triangle that is the bedrock of psychoanalytic theory. Lesbian, gay, transsexual, and single parenting configurations are also considered. Psychoanalysts must acknowledge the changing cultural mores as well as the technological innovations in order to embrace the paradigm of the Modern Family. If we cannot, we may unnecessarily stigmatize it.
Mann's first chapter is entitled “Psychoanalytic understanding of repeated in vitro fertilization trials, failures, and repetition compulsion.” Because fertility issues can be so difficult to diagnose, many