OP0290-PARE Family Planning and JIA: Infertility and Parenthood
Authors: E. Mateus
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> For patients with RMDs, planning a pregnancy often involves reducing its specific treatment and coping with a worthy decreased well-being. However, infertility and subfertility are increasing problems world wide, meaning that patients with RMDs may also have to deal with reproductive disruptions. Reproductive medicine helps individuals to reach their individual goals for a family, but for RMDs patients it implies postponing treatment. Nevertheless, there are situations which reproductive medicine can not resolve. Both women and men experience considerable psychological distress when experiencing reproductive health problems, including feelings of low self-esteem, isolation, loss of control, sexual inadequacy and depression(1). Accordingly, infertility is a source of diminished health and social well-being that can aggravate the RMDs patients' emotional distress. Planning a family after infertility is still possible through adoption. <h3>Objectives</h3> This presentation will focus on overcoming the psychological burdens and fears of denied parenthood in child adoption process. Infertility and its treatment transforms family dynamics and relationships (2) and affects self-esteem. When reproductive medicine fails or can not provide a solution, RMDs patients may find themselves in a worsening physical and emotional condition. Postponing the treatment while pursuing pregnancy can affect the course of the disease. Facing low self-esteem, blaming your own body for failure or your disease due to treatment side-effects, RMDs patients may also have to deal with increased disability and reduced well-being. Both body and science had denied them to fulfil the desire for experiencing parenthood and they may feel that they have failed as social subjects towards their family (spouse and relatives). After subjecting their body to biological screening, applying for adoption can be regarded as process where they need to prove to other experts a social (and physical) ability to raise a child. This parenthood solution can be blocked by the fear of rejection and feelings of unfitness to be a parent. <h3>Methods</h3> I will present my personal story, questionings, feelings and reflections from being a JIA patient who tried to get pregnant. This presentation will provide a reflexive approach to infertility and adoption process. <h3>Results</h3> When you decide to get pregnant you are deciding to reduce your medication. Beside managing reproductive issues you must also manage your RMD, your <i>self</i> and your relatedness to the world. All the risks implied can be worthwhile. But when facing a very low rate of success for any reproductive treatment you may have to decide differently. This anxiety on deciding can be agravated when the child adoption process is a chance for parenthood and constituting a family, but also involves several choices. How are we supposed to choose a child? How can we be chosen to be a parent? This presentation intends to focus on these aspects, sharing a personal account to the discussion. <h3>Conclusions</h3> It is possible to overcome the psychological burdens of infertility and RMDs. Living and coping with a chronicle condition does not disables anyone to be a parent and properly raise a child. Family planning can also involve child adoption. <h3>References</h3> WHO. <i>Genomic resource centre. Gender and Genetics. Assisted Reproductive Technologies (ARTs).</i> Inhorn, M. &amp; Balen, F. (eds) 2002. <i>Infertility around the Globe. New Thinking on Childlessness, Gender, and Reproductive Technologies</i>. UCP. <h3>Disclosure of Interest</h3> None Declared