Infertility as Seen through the Lens of Uncertainty in Illness Theory

Abstract

Infertility affects approximately 10% to 20% of the childbearing age population worldwide. As infertility affects people from all socioeconomic levels and cuts across all racial, ethnic and religious lines, it is a community health problem of significant import. Infertile women report their infertility to be 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. Most research on infertility has been based on theories of stress and coping, but has neglected the concept of uncertainty, which 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, 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. Understanding the role of uncertainty offers important implications for care providers, researchers and their infertile clients.