g. being on the waiting list whilst experiencing a strong reproductive wish, etc.) (Karatas et al. 2011). In our clinic, couples having experienced PGD indicated they found PGD quite burdensome. Couples are offered psychosocial counselling during the PGD process. The psychological function of pregnancy Surprisingly, few studies have evaluated the psychological impact of preconception counselling. In order to grasp the possible psychological impact of being confronted with genetic risk during preconception consultation, it is important to understand the psychological function of pregnancy. It may be assumed that couples,

who AG-881 molecular weight wish to be informed about genetic risks, express their wish to have children and at the same time feel responsible for the future child’s health and welfare. Hence, from a psychodynamic point of view, the couple’s decision to plan a pregnancy represents a developmental milestone and a psychosocial crisis (Leon 1992a). First, the outlook on parenthood might give each of the couple an independent sense of adult identity with different perspectives for the prospective mother and father. In case of hereditary risks, EPZ015666 purchase we have often observed that the mother is particularly concerned with the welfare of the future child, whereas the father feels protective towards the entire find more family system (e.g. the well-being of the other children in the family, maintenance of quality

of life of the family). Second, to both prospective parents, a pregnancy means an enhancement of the self and one’s own importance, and achievement of omnipotent feelings, which may be challenged when the pregnancy is threatened by hereditary risks. Third, longing for a pregnancy also implies that the couple wishes to create a new object relationship which underlines the increasing identification with parental figures in past and present (Leon 1992b). All of these psychodynamic functions of pregnancy may be threatened when couples discover their genetic risk. When couples are offered PCC and are informed about Vildagliptin the genetic

risks for future children, they become aware of the tension between the desire to have, nurture and raise a child on the one hand and their sense of responsibility on the other hand. Parents may experience guilt feelings towards (future) offspring (Strømsvik et al. 2009; van Oostrom et al. 2007; Klitzman et al. 2007). Confrontation with genetic risks and appeal to the feelings of responsibility towards the future child and others involved may attenuate the desire for a pregnancy. Moreover, the marital relationship may be challenged when one member of the couple feels differently than the other with regard to the need to have PCC and the subsequent management (reproductive screening/testing) options, especially if one member of the couple has multiple risk factors and difficulties to adapt.