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That it should be possible to detect psychological differences between women infertile for organic reasons and those infertile through functional or psychogenic causes seems a reasonable proposition. Yet, as Astor and Pawson describe in an introductory review of the literature in this paper, relatively ‘clumsy’ psychometric tests of neuroticism or personality maladjustment generally fail to distinguish between these two groups. They point out that the pattern of emotional response to infertility, detected by psychometric tests, namely surprise, grief, anger, isolation, denial and acceptance, would be common to both groups of patients and would determine the results of these tests. The nature of the underlying conflict is not addressed in psychometric tests because they are not based on the assumption of an internal world, or presuppose the origin of conflict deriving from motivation which is unconscious.
The work of other researchers in devising structured questionnaires of internal conflict and motivation for childbearing, is reviewed. Psychoanalytically-based questionnaires are described which address, for example, the woman's phantasies about the newborn infant, identifications with her own mother, or phantasied child, and the relationship with her own parents.
Referring to their own research in a paper given at the VIIth World Congress of the International Society of Psychometric Obstetrics and Gynaecology, using a psychodynamic interview, the authors identify three subgroups of infertile women: those who do not want to become pregnant but like the idea of a child; those who could not hold on to the baby inside but want to become pregnant; and those who do not want to conceive at all.
The work of other researchers states that unconscious hostility to her own mother may be so great that an infertile woman may feel she would kill a child should she have one. This finding relates to the authors' own current research in that the majority of their functionally infertile