When you cannot become a parent without outside help, making decisions to deal with your longing is a complicated process. This is shown in a new doctoral thesis at the Nordic School of Public Health NHV. "Accepting that you need to seek help to conceive a child is difficult, and men are more reluctant than women to accept and agree to seek specialist help," says the social worker Helga Sól Ólafsdóttir who will defend her thesis on April 13th 2012.

The world of assisted reproduction treatment is confusing, but the couples try to adapt since it is their only possibility to conceive a child together. The research is based on both questionnaires about the structure of assisted reproduction treatments in all of the Nordic countries, as well as interviews with 22 Nordic couples, from the time they had their first appointment at a fertility clinic and again approximately 3 years later.

Even though the Nordic countries are quite similar, there are a few differences regarding assisted reproductive treatment care. E.g. the strictest legislation is found in Norway, the subsidy systems of Iceland is the most complicated, the waiting time for treatments was longest in Sweden and the full cost for treatment in the private clinics is least expensive in Finland and Denmark.

"This research is the story of 22 Nordic couples, from the time they decide it is the "right time" to become parents," says Helga Sól Ólafsdóttir. Of the 22 couples, 17 had become parents after 3 years, some without help, through assisted reproduction, egg donation or adoption. 21 children had been born and one on its way. "Making decisions when dealing with infertility is based on negotiations and re-negotiations between two individuals. One may be ready while the other is not and the process to come to an agreement is constantly affected by outside factors," says Helga Sól Ólafsdóttir.

She found that the individual process is highly affected by the available options, i.e. what is allowed and possible to do, the stability of the social situation, opinions of friends and family, and in particular the influence from specialists and other health care personnel.

Helga Sól Ólafsdóttir stresses the importance of health care personnel that meet infertile couples to be aware of the different stages people can be at and how they influence the couples' decision-making process, and that they must strive to adjust the care to the need of the couple. "The couples wish to been seen and listened to more closely," says Helga Sól Ólafsdóttir.