A Case of Sterility

In September 1941 Sylvia, a married woman of thirty-five, came to analysis in a state of acute neurotic depression. Her first account of the reasons for her depression was that during her ten years of marital life she had failed to become pregnant. The cause of her sterility was apparently ovarian deficiency. After two years of regular periods, her menstruation had suddenly stopped at the age of sixteen and for about nineteen years she had been amenorrhoeic. Medical treatment had failed to reinstate her menstrual cycle.

In the summer of 1941 Sylvia had attempted to adopt a seven-month-old girl through an adoption agency which informed me that when she saw the child for the first time she displayed conspicuously ambivalent behavior marked by apparent disappointment. During the trial period preceding the legal adoption, the agency's social worker noticed in Sylvia an increasing feeling of insecurity, anxiety, doubt and depression coupled with a compulsive behavior in the handling of the baby, who quickly changed from a happy, into a disturbed, anxious child. After ten weeks of growing difficulties, Sylvia went to the hospital for a hemorrhoidectomy, first bringing the baby to the agency and asking them to keep it in a nursery home during her hospital stay. At the same time she expressed serious doubts about keeping it, whereupon the agency decided to take the child back. Sylvia reacted to her failure with such a severe depression that the consultant psychiatrist of the agency recommended analytic treatment. Sylvia interpreted the suggestion as a vague promise of another baby should she be cured.

The physical appearance of the patient betrayed at first sight definite glandular disturbances. She looked very much underweight, exceedingly frail and childlike; her boyish figure lacked female roundings, her breasts were small, her legs, shoulders and arms very skinny. According to her, she had