TONTHaONGTAMLY
6 PHU NCf HIEM MUON CON
QUA PHAN TICH TRUONG HOP
Nghien cCru nay dtrgc tai trg bdi Quy Phat trien khoa hgc va Cong nghe Quoc gia
(NAFOSTED) de tai: Kho khan tam ly cua cac cap va chong hiem muon con; Ma so
501.01-2019,03; Trudng Oai hoc Khoa hgc Xa hgi va Nhan van chij tri; TS. Trirang
Quang Lam lam chO nhiem.

Truong Quang Lam

Trudng Dgi hgc Khoa hgc Kd hgi vd Nhdn vdn, Dgi hgc Quoc gia Hd Ngi.
TOM TAT

Tinh trang hiem mudn con Id mdt thdch thiic ldn cho cdc cdp va chdng vi Idi
chinh, sire khoe the chdi vd tinh Ihdn tren hdnh trinh "tim con". Qua viec phdn tich ba
Irudng hgp dien hinh cho thdy, cd ba ngudi deu cd nhirng Idn thuang ldm ly nhu: vdn
de ve cam xiic lieu cue (lo ldng, sg hai, that vgng...), gap dp lue tir gia dinh vd xd hgi,
tu li ve gid Iri bdn Ihdn, dp luc ve tdi chinh. Ket qud phdn tich ba trudng hgp phu nQ
hiem mudn budc ddu tim hieu tdn thuang tdm ly eua ngudi vd sinh, hiem muon, tren ca
sa do, bdi viel cung dua ra mdt sd bdn ludn cho cdc hudng nghien ciru tiep theo.
Tir khoa: Vo sinh; Hiem mudn; Tdn thuang tdm ly.
Ngdy nhdn bdi: 2/2/2020; Ngdy duyet ddng bdi: 25/2/2020.
1. Dat van de
Sinh san, nuoi duong va giao due con cai la mpt trong nhiing chuc nang
ea ban ciia gia dinh. Buae vao cuoc song hon nhan, chao don dua con ra doi la
mong uoc cua tat ea eae cap va chong. Trong van hoa phuang Dong va 6 Viet
Nam, viee dong con nhieu chau eo the duge coi la mot trong nhiJng chuan mue
hang dau eua hanh phiic trong nhieu gia dinh. Tuy nhien, dieu luang chiing
nhu gian dan do lai tra nen het sue kho khan vdi nhirng nguai roi vao tinh
trang vo sinh, hiem muon. Dieu do da lao ra nhieu ap Iuc lon doi vai cae cap
vg chong, dae biel la doi vdi ngirdi phu n\x. Ho phai chiu nhung thanh kien nhu

"cdy dgc khong trdi, gdi doc khong con" hay ""cdy kho khong co lgc, nguai dgc
khong CO con". Ngay ca khi nguyen nhan hiem muon tii phia nam gidi, thi phu
nu van chju ap luc sinh eon, tham chi trong nhieu gia dinh, ngudi phu nii phai

TAP CHI TAM LV HOC, Sd' 3 (252), 3 - 2020

83


CO con bang moi each d^ co dugc hanh phiic gia dinh... Di6u nay tao ra nhieu
ton thuong tam ly cho ho tren hanh trinh "tim con".
Theo bao cao cua To chiic Y te The gioi (WHO) ve dir lieu Khao sat
Nhan khju hoe va Y tl (2004), uoc tinh co hon 186 trieu phu nu da tirng ket
hon 6 do tuoi sinh san cr cac nuoc dang phat trien dang duy tri "uoc mo tre
em", cii bon cap vg chong thi co mpt cap bi anh huong bcti vo sinh. Vo sinh
dugc uoc tinh anh hucmg tu 37 den 70 trieu cap vg chong tren toan the gitDfi
(Boivin, Buntin, Collins va Nygren, 2007). Trong nam 2010, co khoang 48,5
trieu cap doi tren toan the gioi hi vo sinh (Mascarenhas, Seth, Ties va cong sir,
2012). Nam 2012, WHO da chi ra rSng, ganh nang tong thi cua vice bi vo sinh,
hiem muon o phii ntr tren 190 quoc gia van tuong tu ve muc dp va xu huong
nhu tit nhung nam 90 cita tbl ky XX din nam 2010. Vo sinh, hiem muon dugc
danh gia la mgt trong nhiing trai nghiem cuoc song cang thang cua con nguoi.
Ben canh do, qua trinh dieu tri cung gay ra nhirng khung hoang cuoc song eho
cac cap vg chong (Menning, 1980; Dunkel-Schetter, I99I; Lalos, 1999).
Tai Viet Nam, nghien ciru tren toan quoc do Benh vien Phu san Trung
uong va Dai hpc Y Ha Npi (2015) tien hanh tren 14.300 cap vg chong trong dp
tuoi sinh san (tir 15 tuoi den 49 tuoi) cf 8 tinh dai dien cho 8 vimg sinh thai eita
Viet Nam cho thay: Ty le vo sinh ciia cac cap vg chong trong dp tuoi sinh san
la 7,7%, trong do vo sinh nguyen phat la 3,9% va vo sinh thir phat la 3,8% (50%
so cap vg chong vo sinh duoi 30 tuoi) (dan theo bao dien tir dantri.com).

Nhu vay, co the thay, vo sinh, hiem muon dang la ganh nang cho rat
nhieu gia dinh, khong eh! ve tai ehinh, ma no con la nhOng ap lire tSm ly cho cac
thanh vien trong gia dinh, dac biet la doi voi cac cap vg chong. Vo sinh, hiem
muon tao ra nhirng ton thuong tam ly cho con nguoi, cting c6 the dan den dau
kh6 vil tram cam ciing nhu su ky thi va tay chay (Cui W., 2010; Chachamovich
va cpng su, 2010). Nhtrng ton that nay cang nghiem trpng htm doi vai nguoi
phu ntr, boi hp cam thay tuyet vpng, mac cam ve ban than va mkt kien nhSn
trong qua trinh diiu tri hilm muon (Deka, Sarma, 2010). Phu nir vo sinh eo tu
bao cao thap hon ve sire khoe tam thiin, boat dpng xa hpi va hanh vi tinh cam
(Chachamovich va cpng sit, 2010). Ngoai ra, thoi gian vo sinh, hilm mupn c6
tuong quan nghich vol diem so vl su hai long trong hon nhan. Nhung benh
nhan trong thoi gian dai khong co con thucmg co chit lucmg hon nhan kem.
Thoi gian vo sinh co lien quan viJi nhilu phan iing cam xiic khac nhau (vi du
nhu lo au va trim cam) va chat lugng cuoc sing (Reza Omani-Samani, Saman
Marouftzadeh va cpng su, 2017).
0 Viet Nam, da co mgt so nghien citu ve anh huong ciia tinh trang vo
sinh, hiem mupn doi vol tam ly cua nguoi hilm muon. Nghien euu eiia Nguyen
Thi Hang Phuong (2011a) da chi ra, nguoi pbii nit trong hoan canh hilm

84

TAP CHi TAM t y HOC, So 3 (252), 3 - 2020


mupn, vo sinh da phai chiu dimg mgt ap luc kep. Do la mong mu6n sinh dugc
mgt diia con va thai dp do xet, ehi trich cua nhirng nguoi xung quanh, tir hang
xom, ban be co quan, khu phi... din nhiJng ngucri than thupc nhu gia dinh nha
ching va ngay ca chpng cua hp. Nhifng ap lire tam ly dp da khiln phu nii roi
vao trang thai chan nan, nang suat lam viec giam siit... Mpt nghien cim khac,
tac gia da chi ra nhung ton thuang ve cam xuc lon nhat ciia phu nil la dau don

trong tam bin (89,6%), chan nan (87,9%), tuyet vpng (87,3%i), cam thiy tui
thiin (85,4%)... Theo tae gia, mpt trong nhirng ly do din din viee kho hoac
cham mang thai hon la vi phu ntr hiem mupn thuong xuyen g trong trang thai
lie che (Nguyen Thi Hang Phuong, 201 lb).
Nghien ciru ciia Nguyen Do Hong Nhung, Nguyin D 5 Huong Giang
(2017) cho thay, cac bieu hien kho khUn tam ly 6 nguai vo sinh, hiem muon
gap phai nhieu nhat la tinh trang lo au cang thang vi khong co con; bi quan,
chan chuong vi thcri gian dieu tri keo dai; thit vgng vi chua dupc den dap va
mac cam tu ti thua kem. Da so nguoi vo sinh mong muon va rat mong muon
dugc cham soc sire khoe tam than.
Nhin chung, cac nghien citu va qua trinh dieu tri cho ngucti vo sinh,
hiem muon da dat dugc nhieu thanh tuu lan duoi goc dp Y hpe, tuy. nhien, eac
nghien ciiu ve ton thuang tam ly ciia nguai vo sinh, hiem muon thuc sir van la
mpt khpang trong chua dugc quan tiim nhieu. Nhirng nam gan diiy, cac van de
tam ly ciia nguoi vo sinh, hiem muon dugc nhac den nhieu hon tren cac
phugng tien truyen thong dai chung. Tuy nhien, viec xac djnh nhiing kho khan
tam ly ciia ngucri vo sinh, hiem mupn vin can nhieu nghien citu hon nOa. Vi
vay, muc tieu cua bai viet buijc dau phan tich nhiing ton thuang tam ly o nguiji
phu nit hiem mupn con qua viee phan tich ba trucmg hgp dien hinh. Scr dl
chiing toi chgn nghien eiru tren khach tbl la phu nu boi nhieu nghien ciru chi ra
rang ton thuang o phu nil lijn hon so veil nam gicSi (Deka, Sarma, 2010), nhung
ap luc tam ly ciia ngucri vp phiii ganh chiu la lon hem, ngay ca khi nguyen nhan
ciia viee khong eo con tit phia ngucri chong (Lee va Sun, 2000) va nhttng nguoi
phu ntr hilm mupn co chat luong cupe song thap han so vai chong ciia hg
(Goker, Yanikkerem, Birge va Kuscu, 2017).
2. Khai niem cc ban
2.1. Vd sinh, hiem muon
Theo tac gia Vu Van Du (2017), vo sinh la tinh trang mpt cap vg ching
khong tbl CO thai sau mpt nam chung sing, giao hgp binh thudng, khong ap
dung bien phap tranh thai. Ty le vo sinh a nu chilm khoang 30 - 40% eae

truang hgp, vo sinh a nam chilm khoang 30%. cac truang hgp, khoang 20%
cac trudng hgp la nguyen nhan a ca hai vg ching. Ben canh do, co khoiing 10 15% cac cap vg chong khong tim thiy nguyen nhan gay vo sinh.
TAP CHI TAM Vi HOC, Sfi 3 (252), 3 - 2020

85


Vo sinh CO the duge phan thanh 2 loai: 1/ Vo sinh nguyen phat la trucmg
hgp mpt cap vg chong chua timg co thai, mac dii da song vai nhau tren mpt
nam va khong diing bien phap tranh thai. 2/ Vo sinh thii phat la trucmg hgp cap
vg chong da co con hoac da co thai, nhung sau do khong the co thai lai mac du
dang sing vo'i nhau tren mpt nam va khong dung bien phap tranh thai (Bp Y te,
2015).
v l khai niem vo sinh, hiem mupn, theo cac tai lieu tieng Anh co nhieu
thuat ngu khae nhau. Theo Uy ban quoc te giam sat ho trg cong nghe sinh san
va T6 chuc Y tl Tbl giai, thuat ngir Infertility dupe dinh nghTa la benh ctia he
thing sinh san dupc xac dinh boi su thit bai trong viec mang thai sau 12 thang
hoac hon, viJi tinh trang quan he tinh due khong sti dung biit ky bien phap
tranh thai nao (Zegers-Hochsehild va cpng su, 2009; WHO, 2013).
Theo Tit diln Y hpc Anh - Viet (2007), tir infertility la tinh trang khong
tbl mang thai dupc sau thcri ky 12 thang quan he tinh due binh thuong ma
khong diing bien phap tranh thai. Mot tit khac la subfertility - dupe hieu la mpt
ngudi nao do duge mo ta la van co co hgi co thai tot, mac dii co the mat nhieu
thdi gian hon nhung ngudi khac (Evers, 2002). Diiu nay dugc so sanh vdi
infertility, la nhOng ngudi can ho trg y tl dl co thai. Vdi trudng hgp dae biet
khong CO con do khong c6 kha nang sinh san dugc hieu la vd sinh (sterility).
Theo thuai ngil tieng Anh, ea "infertility" va "subferility", cac cap vg chting
deu CO ca hgi mang thai dudi sir bo trg cua y hgc. Vi vay, chung toi tan thanh
vdi thuat ngu "hiem muon" khi nghien citu ve ton thuong tam ly ciia ngudi
dang tren hanh trinh "tim eon", nham giam ap luc tam ly cho cac cap vg chong

trong qua trinh nghien citu.
2.2. Tdn thuang tdm ly ffphu nd- hiem mudn con
Theo dinh nghla thong thudng, ton thuang la su hu hai, mat mat mgt
phan nao dd. Thit hi ton thuang khong cdn duge nguyen ven nhu trudc nita
(Van Tbi Kim Ciic, 2016). Theo Pearlman va Saakvitne (1995), tin thuang
tam ly la trai nghiem ea nhan doi vdi mgt sir kien hoac cae sir kien lau dai, bao
gom: kha nang tich hgp trai nghiem cam xue ciia ca nhan la qua siic chiu dung
hoac nhung trai nghiem chii ijuan ciia ca nhan nhu la mil de dga doi vdi sir
sing, tinh toan ven ciia co thi hoac sir tinh tao cila ea nhan (din theo Esther
Oilier, 1999). Cdn theo tac gia Huynh Van Son (2019), tin thuong tam ly la
trang thai tam ly sau khi ca nhan trai nghiem nhtrng su kien bit thudng, de dpa
sit toan ven, yen In ve tbl chit hoac tinh thin cua hg, cd anh hudng tieu cue
din boat dpng song cua ea nhan. Cac sir kien gay tin thuong tam ly thudng
bao gom lam dung quyen Ittc, phan boi long tin, su mic ket, bit lire, dau dan,
sir hoang mang va/hoac mat mat. Nhttng diiu nay lam lin at kha nang duong

86

TAP CHITAM Vi HOC, S6' 3 (252), 3 - 2020


diu ciia ca nhan (Esther Ciller, 1999), la nhirng ylu t l Iam dao dpng, tham ehi
dao lgn trang thdi can bang tam ly, thudng tac dpng tieu cite din sir phat triin
binh thudng (Van Thi Kim Ciic, 2016).
Tren thuc te, ton thuang tam ly cQng phu thupc vao titng ea nhan, timg
su kien tac dpng, timg boi canh.._. Hai ngudi cd thi trai qua ciing mpt su kien
dpe hai va mpt ngudi cd the bi tdn thuang trong khi ngudi kia van cdn tuong
dii binh tmh. Ngoai ra, cac khia canh cu thi cua mpt su kien gay chin thuong
se khac nhau tit ca nhan nay sang ca nhan khae. Dieu dd phu thugc vao van
hoa, vao thdi dai, vao kha nang chju dung ciia moi ngudi, vao y nghla cua su

kien dii vdi ngudi dd (Esther Oilier, 1999; Van Thi Kim Cue, 2016).
Cac nghien ctiu tren da chi ra, vice khong cd con cai da tao ra nhilu ton
thucmg cho cac cap vg chong, nhat la doi vdi ngudi phu nil nhu; dau kho (vi
khong sinh dugc con), tuyet vpng (vi that bai trong nd luc diiu tri), mac cam vl
ban than... Do do, khai niem tdn thuong tam ly d phu ntt hilm mupn con dugc
hieu Id nhung dp luc vd trdi nghiem cdm xitc qud sire chiu dung, dnh hirdng tieu
cue den tdm ly vd the chat ciia ngirdi phu nir tren hdnh trinh "lim con ".
3. Phiro'ng phap vii dao diic nghien ciru
3.1. Thiet ke nghien ciru
Nghien ciru trudng hgp duge ap dung it khai thac dupc chieu sau ve
mat tam ly nhiing trai nghiem ciia phu ntr hiem mupn eon.
3.2. Mdu nghien cieu
Khach the la ba phu nil da dugc tham kham va dugc y hgc ket luan la vo
sinh nguyen phat. Day la nhiing phu nu chua tirng mang thai, sinh eon, ding
thdi hp da co nhOng trai nghiem that bai trong dieu tri vo sinh, hiem mupn.
Trong nghien ciru nay, mau nghien ciru dugc chgn ngau nhien, thuan tien, bdi
viee lira chpn khach the de nghien ctiu la het site khd khan, tam ly chung eua
benh nhan hiem mupn la phdng ve cao, khong sin sang tra ldi. Chung toi da
lien he vit ed dupc stt dong y ciia mpt phdng kham hiem mudn tren dia ban Ha
Npi, dong thdi eung dugc sir dong y cua ba benh nhan nil. Thdng tin ve eae
trudng hgp cu the nhu sau:
Trudng hgp T.: 29 tudi; que quan: Me Linh - Ha Npi.
Nghe nghiep: Kinh doanh buon ban.
Ket hon tir nam 2017, thdi gian hiem mupn la 3 nam.
Tinh trang siic khde: vg bj tic vdi triing, chdng bi tinh triing yeu. T. da
ba lin lam bien phap bam tinh triing vao buing trung (lUI) va mpt lin chuyen
phoi bang bien phap thu tinh trong dng nghiem (IVF).

TAP CHI TAM L f HOC, So' 3 (252), 3 - 2020


87


Trudng hap H.: 30 tudi, que quan: NghTa Dan - Nghe An.
Nghe nghiep; giao vien mam non. Thdi gian hiem mupn con la 3 nam
(kit hdn tit nam 2015, den nam 2017 mdi co ke hoach sinh con).
Tinh trang sire khde: vg bi viem 16 tuyen, chu ky kinh khong deu, sue
khde eua ching binh thudng. H. da lam lUI 4 lan (3 lin d benh vien tinh Nghe
An va 1 lin d Ha Ngi), du kien se lam IVF vao nam 2020.
Trudng hgp M.: 33 tudi, sinh sdng tai Nha Trang, Khanh Hda;
Nghe nghiep: ST quan quan dpi.
Kit hon tit nam 2014, thdi gian hiem mupn eon la 6 nam.
Tinh trang sire khde: vg bj buong triing da nang, chong bi tinh triing
ylu. Nam 2017, M. da diiu trj bing bien phap IVF trong benh vien T.D. 1 lan.
Nam 2019, vg chdng M. da ra benh vien B.D. d Ha Ngi va diiu trj IVF Ian 2.
3.3. Cdng cu nghien ciiu
Bang hdi phi ciu true dugc xay dung dua tren eac nghien cuu tren the
gidi va d Viet Nam vl vin de phu nii' hilm mupn de thu thap dQ lieu. Qua tritih
phdng vin dugc thuc hien linh boat, tiiy titng hoan canh, tinh huong ciia tien
trinh phdng vin khach the nham khai thac va lam ro nhiing ndi dau ma hg dii
va dang trai qua. Vi du mpt so cau hdi nhu: Anh chi mong cd con duac bao
idu? Khi bdc si kit ludn tinh trang la vd sinh, cdm xuc ctia chi nhu the ndo?
Nhirng dp lire ndo md chi da vd dang trdi qua trong tinh trang hiem mudn?
Trong qud trinh chira tri hiem mudn, vg chdng chi gap nhirng khd khan ndo?
Cupe phdng van vira dugc ghi am vdi sir dong y cua khach the va vira ghi chep
bdi nha nghien ciru.
3.4. Phdn tich dd- lieu
Phan tieh dir lieu dugc dua tren cac thong tin ma khach thi cung cip.
Dau tien, cac ban ghi iim dugc danh may lai chinh xac cac cau hdi va tra Idi.
Sau dd, nha nghien citu dpc kT lai ca 3 ban ra bang dl tim kilm cac chil dl khac

nhau cd lien quan den trai nghiem ton thuong tam ly. Sau dd, qua trinh ma hda
dugc tien hanh vdi timg doan ctia loan bd 3 ban ra bang dira tren y nghTa ctia
cac cau ed lien quan, phan anh tirng chii dl. Qua trinh phan tich se diia tren
timg chu de nay de trich rut dii lieu.
3.5. Dgo dire nghien ciru
Cac khach the da dugc trao ddi trudc vl noi dung nghien eiiu, dugc giai
thich ro ve muc dich nghien eiru, dd la de tim hiiu nhiing kho khan va nhtrng
tin thuang ciia ngudi phu nu dang trong tinh trang hilm mupn eon. Cae thdns

TAP CHITAM Vi HOC, Sd 3 (252), 3 - 2020


tin ca nhan hoan toan dugc gia bi mat, ten cua hp da dugc vilt tit trong bai
vilt. Khach the cung dugc khuyin cao la cd tbl tir chii tham gia nghien ciru
bit c i khi nao hp cam thiy khong phit hgp hoac cd tbl tir chii tra ldi nhttng
cau hdi ma hp khdng mudn tra ldi. Viec phdng vin sau duge thuc hien khi
khach tbl trong trang thai khde manh, san sang chia se.
Cac cudc phdng van sau dugc diin ra trong mdi trudng an toan, nlng
im, cac khach the san sang chia se. Cimg vdi qua trinh thu thap thdng tin,
chiing tdi ciing lang nghe va thau cam vdi nhtrng cam xuc am tinh ma cac
khach the dang trai qua, Khi cac khach the cd su binh In vl tiim ly, hg cd tbl
chia se nhieu hon ve nhiing khd khan dang va sip trai qua. Vi vay, nghien cilu
nay khong di sSu phan tich theo hudng phuc trinh ca tham vin, ma muc dich
phan tich nhung bilu hien tin thuang tam ly ctia nhttng phu nu da va dang trai
qua tinh trang hiem mudn con.
4. Nhu'ng ton thu'gng tam Iy ciia ba chan dung tam Iy
4.1. Cdm giac tuyet vong
Nhttng trai nghiem cam xuc tieu cue la van de ldn nhat ma cii ba ngudi
phu nu deu trai qua tir khi hp mong cd con. Trudc bet la tam trang met mdi ciia
ba trudng hgp trong thdi gian dai da dieu tri biing thudc ddng y nhung khdng

hieu qua. Ben canh dd, ve mat tam linh, gia dinh hg cdn di cau eiing, le bai d
nhieu noi vdi tam ly la "ai mach gi cung lam, nghe ndi chd nao chua dugc
cung tim den" - trudng hgp T. Vg chdng hp da tdn rat nhieu tien cau cung, theo
nhieu thay ciing bai met mdi ma khdng cd duge eon - trudng hcrp M. Khi
chuyen sang chtta bang tay y, cam xue dau tien la ca ba trudng hgp deu hi sdc
va bj ap luc rat nang nl khi nhan ket qua la vo sinh nu (dii nguyen nhan la tu
phia ngudi chdng nhu trudng hgp T.). Dieu dd lam tang them ap lire va su lo
lang cho ngudi phu nu, hp cam thay nang ne, tuyet vpng khi nghe lit "vd sinh"
- Uudng hgp M. Dac biet la hp thay ap lire ban vdi gia dinh nha chdng bdi "khi
biet benh an nhu vay thi cam giac nhu gia dinh hp khdng cd chau la ldi tai
minh chii khdng phai la tai con trai hp" - trudng hgp M.
Chung tdi nhan thiy, nhttng tin thuang vl cam xuc dien ra nhieu hon d
ca ba trudng hgp trong sudt qua trinh dieu tri bang lay y va sau khi dieu trj gap
thit bai. Cu thi:
Trudng hap T.: Khi chuyin sang diiu trj tay y, vg chdng T. da 3 lan
dieu tri hiem mupn bang bien phap lUI, nhung roi ket qua deu that bai. Sau
mdi lin nhu vay, T. lai bj eang thing vl tam ly, sir that vgng va ap luc vi
khdng sinh dupe eon lai cang tang len. Ndi ve nhttng trai nghiem da qua, T.
cho bilt dpng lai trong tam tri la nhttng ky lie budn dau, hy vgng rdi lai that
vgng. Nhit la trong qua trinh diiu trj, T. cd cam giac don ddc, chan chudng va
TAP CHI TAM Lt HOC, S« 3 (252), 3 - 2020

89


khdng biet den khi nao mdi cd dugc con. Quiing thdi gian hai nam dieu tri a
benh vien, nhung ngay tiem kich trirng la nhttng ngay T. khdng the quen. T. bi
am iinh bdi nhung miii tiem va sg doan dudng ma T. thucmg di den benh vien
de chua benh: "Cdm gidc den benh vien mgt minh de tiem sao thdy con dudng
dd ddi ddng ddng, sao ndng ne vd ddi kinh khung, vi con md em phdi cd" - T.

ndi trong nude mat.
Dac biet, ndi dau khd irong T, tang len la khi ket qua dieu trj bang bien
phap IVF gap that bai. Cu the, nam 2019, vg chdng T. phai chuyin sang bien
phap IVF, vdi T., day hy vpng cudi cimg de cd dugc dira con nen T. da cd gang
giu tinh than lac quan de duge ddn tin vui. Tuy nhien, ket qua lai khdng dugc
nhu mong mudn: chat lugng phdi ciia vg chdng T. khdng tdt, phdi khdng phat
triin. Nhic lai dieu nay, T. cam thay dau khd vi trong tinh cam dd T. "mudn
khde ma khdng khde dugc". T. chia se: "Hdm vg chdng em vdo benh vien
chuyen phdi, bdn thdn em dd chudn bi tinh thdn vd cd cd su- hao hung cho mdt
hy vgng mdi, nhirng bdc si gap rieng em vd ndi rdng phdi cita chung em khdng
phdt trien vd do do khdng chuyen duac. Luc do cdm gidc moi thii nhu sap lai
trudc mat, em lui thiii budc ra khdi phdng vd khdng biet ndi gi, em dau khd
ldm" Ci thdi diem hien tai, T. cam thay dau khd, cd dan va hoang mang vi
khdng biet sap tdi se nhu the nao.
Trudng hap H: Trong thdi gian hiem mupn ba nam, chi H. cung da trai
nghiem nhieu ciim xuc budn dau ddn nen. Trong sudt thdi gian mong chd cd
con ma chua cd dugc va trai qua nhung that bai sau 4 lan dieu trj bang bien
phap lUI, H. cho biet la da trai qua qua nhieu cay dang vi "vira mdt tien chua
tri, vira tdn bao nhieu cdng sire md cuoi ciing kit qud lai vi khong". NghT v^
viee khdng cd dugc con, nhieu dem H. lo lang qua muc din din bj mit ngu,
tham chi, ndi lo sg khdng sinh dugc con edn khien H. bj am anh trong giic mo.
H. ndi: "sau nhirng ldn Ihdi bai do em nghi rdt nhiiu, em cdm gidc budt nguc,
khd thd md khdng biit ldm the ndo" - H. bj roi loan kinh nguyet va cd nhilu lin
bi mat kinh, bac sT ket luan nguyen nhan la do hi ap luc vl tam ly.
Vdi H., viec chtta trj dl cd con cd nhttng khd khan khac vdi nhilu phu
ntt hiem mupn khac bdi khoang each ve dia ly gitta noi chi sinh sing va co sd
diiu trj qua xa. Viec di lai lu nha ra benh vien tinh Nghe An trong 3 lin diiu trj
lUI, rli dgt diiu tri thu 4 di tit Nghe An ra Hii Ndi (chi bit xe di Ha Npi tii
hdm trude, chieu hdm sau tit Ha Npi vl Nghe An) khiln chj met mdi vl thi
chit va tam trang. Ben canh dd, cung giing nhu trudng hpp T., trong nhttng

ngay tiem kieh trimg, theo doi tning chin, mdt minh chj phai tu di (vl ching ban
cdng viec). H. eOng trai qua tam trang don ddc, cam giac phai tit than mpt minh
duong dau vdi hanh trinh "tim con", H. chai ly vdi mOi tiem, do diiu kien di lai
khd khan nen H. tu tiem thudc cho minh d nha ma khdng cin din sir hd tro.

90

TAP CHi TAM Vi HOC, SS 3 (252), 3 - 2020


Trudng hap M.: Khi dugc hdi vl nhung gl da trai qua trong thdi gian
hilm mupn, M. cho biet dd la quang thdi gian nhilu ap lyc va cang thing.
Nhung mat mat da qua vai chj la "khdng the ndo quen trong cudc dai". Tir luc
nhan kit qua benh an ket luan la vd sinh, chi roi vao tinh trang cang thing, mit
ngO va lo sg trong thdi gian dai "vi vd sinh Id khdng tlie sinh duac con" (cung
giong vdi trudng hgp H,). Khac vdi hai trudng hgp tren, M. diiu trj bing bien
phap IVF ngay sau khi cd kit qua tham kham cua benh vien. Trong suit qua
trinh diiu tri, tir thdi dilm tiem kich tning, chpc hut triing, nudi ciy va chuyin
phdi... dd la tam trang lo lang, hdi hop, hy vpng va rdi lai that vpng.
Ca hai lan thit bai trong lan dieu trj IVF da khien M. c6 nhilu tin
thuong. Cd phan may man hon trudng hgp T. la ca 2 lan M. deu chuyin phdi
IVF thanh cdng, dieu dd da tao ra cho M. nhieu hy vgng. M. c6 cam xuc tit hao
va may min vi dugc mang bau, dugc lam me. Nhung ndi dau ctia M. lai la mpt
dang khac - dp la ndi dau ctia mot ngudi phu nu mat con, hiit hang va that
vgng. Mdi lan nhd lai ky ire do, M. tiec quang thdi gian mang bau tuoi dep,
nhung lai cang thay dau ddn va tu dan vat ban than vi "khdng biit minh cd Idi
gi de din mirc phdi bi nhu vdy". Nhung ndi dau do khien M, roi vao trang thai
tuyet vgng: "nhieu khi di dudng nght din nhung khodng thdi gian do nhu
ngudi mdt hdn, cdm gidc nd dau md minh khdng ndi duac lin ldi'\ Sau'nhttng
cd gang de cd con ma khdng dugc den dap, nghT vl tuong lai, M. cam thay

hoang mang va cd cam giac can kiet nang Iugng: "Em khdng biit lieu minh
chdng dd duoc din bao gid?" - M. ndi.
4.2. Cdm gidc minh Id ngu-di phu nii- vd gid tri trong mdt gia dinh va
xd hpi
Truang hgp T.: Tren hanh trinh "tim con", diiu T. cam thiiy may man la
cd chdng ding hanh, hiiu va chia se vdi vg vc tinh than cung nhu cac cdng
viec trong cudc sdng. Tuy nhien, trong mdi quan he vdi mpi ngudi xung
quanh, nhat la vdi gia dinh nha chdng, T. ludn cam thay cd ap lire vd hinh, bdi
chdng chj la con trai duy nhit. Mac dii, sau khi dieu trj, sire khde ciia chj da
duge kit luan dii diiu kien dl co con nhu ngudi binh thudng, nhung chi cho
biet: "cdm gidc trong mdt cua gia dinh nhd chdng, minh Id ngudi vo gid tri, vl
khdng biit de". Nhilu lin me ching T. khde vl viee chj khdng sinh duge con
khien chj them eang thing va dau khd, tu din vat ban than, mac dd chdng T.
cung cd vin dl vl sire khde sinh san. Tir nhung ap lire, cang thang ve cam xiic
va thit bai trong diiu trj, T. din din it gap gd ban be, it tham gia vao cac cudc
di choi cung nhdm ban. T. sg va chan ghet nhttng ngay ll tit, gid chap trong
gia dinh. Nhtrng ngay nghi le nhu mpt cue hinh vdi T. bao nhieu nam liii thiii
mpt minh, rdi ty co rut lai khdng mudn gap ai. T. cho biet "co ngudi tdt thi hdi
quan tdm, ngudi dc mieng thi hg hdi ldm minh dau ddn: tit a, khdng de duac

TAP CHI TAM LY HOC, Sd 3 (252), 3 - 2020

91


thi sdm mudn nhd nd (nhd chdng) cdng trd vi nai sdn xudt (vi nhd bd me_ de),
dn thi khde md khdng di duac d?...". Nhttng cau ndi ctia mpi ngudi khien i.
cam thiy hi xiic pham, dan dan anh huting den hinh anh ban than, chj cam thay
"minh khdng cd gid tri" vi khdng sinh dugc con. Nhung tdn thuang nay F.
khdng chia se duge vdi ai, ngay ca vdi bd me de ciia T., vi cd ndi ra ihi cung

chi lam eho hg them lo lang, budn dau.
Trudng hgp H.: La dau thii trong gia dinh cd ba anh chj em, vg chdng
anh ca da cd hai con va mdi day da sinh dua thu ba, dieu nay khien H. cam
thiy ap luc, cang thang tir ben trong. Vdi nhung that bai dieu tri, 11. cung xac
djnh tam ly la nlu sau 5 nam chiia iri ma khdng thanh eong, H. chap nhan ly
hdn "cho ching iiy vp khac", mac dit H. cam thay dau khi ndi ra dieti nay
nhung H. cho do la diiu cam thiy nen lam. Khi biet tin chi dau mang bau H.
cung mung cho chi iy, nhung H. cam thiy ttii than trong Idng. H. gap ap lyc
vdi su hdi tham ciia mgi ngudi: Mdi khi cd ngudi than trong gia dinh den tham
chj dau, hp lai chuyin sang cau chuyen "khdng sinh dugc con" cua H. Chi cho
ring, hg bang ben nha chdng khdng phai ai cung yeu thuong minh: "Cd ngudi
hdi true tiip, cd ngirdi thi hdi qua bd me chdng Hg hiiu hg thirang thi khdng
sao, ngudi khdng thuang hg cd cdch nhin dc y, cd ngudi vd tu cudi ndi den
mirc vd tdm". II. bj tdn thuang nang ne, bj am iinh ca vao giac ngii vi nhung
cau ndi nhu: "Idy vi rdi thi de di chir, sao bung cir xep lep mdi the? ..". Chi ed
cam giac bi quy gan, tham chi bj ky thj vl khdng lam trdn chirc nang: "Em
nghe nhung khdng biit trd ldi sao, bdi de duac thi tdi da di rdi, minh cd mudn
nhu vdy ddu". Dan dan, chj ban che giao tiep vdi gia dinh nha ehdng, chi cho
biet la hang ngay chu ddng di lam tir sdm dt;n tdi mupn, ve nha dpn dep an
udng xong la vao phdng di ngu. Trong cac cdng vice gia dinh, mgi ngudi nghT
la H. ranh (khdng bau bi nang nhoc) nen giao nhieu viec cho chi: "em di ldm cd
ngdy vi em ciing met ldm, ciing mudn nghi ngai, nhung minh khde manh han,
minh khdng bdu bi nin cdc viec trong gia dinh minh lai phdi ldm". H. cho biet
ban than chj rat khd chju nhung khdng ndi ra dugc vdi ai, vi vay phai de nen.
Trudng hgp M.: Chj cam ihay ap lyc khi mpi ngudi trong gia dinh hdi
tham, 6 nam ket hdn nhung khdng sinh dugc con, ap lyc ldn nhit cua chj lit vdi
chlng._ Cam xuc ciia M. la thay thuong minh, thuong ching, cam thiy ed loi
vdi chdng vi minh khdng dc dugc con cho chdng: "Va chdng ngirdi ta cd con
cd cdi, mirth cir nhu cdi cdy khdng hoa khdng trdi, cdm thdy tiii Ihdn vd ciing.
Hai lan dieu tri IVF that bai, M. ludn tu day dut, din vat ban than: "Em tu hdi

Id minh dd ldm gi, khdng biet minh cd ldi gl md em lai bi rai vdo iinh cdnh nhu
vdy. Cdi tiec nudi (phdijhai) dy mgt phdn, nhiiu khi cit day dirt lai Id khdng
hiiu minh sai a ddu, M/ d chd ndo di md khde phuc". Ben canh dd, ddng
nghiep, ban be hdi han vl chuyen con cai M. diu ne tranh, chi cho bilt la ban

92

TAP CHi TAM Vi HOC, So 3 (252), 3 - 2020


than cung khdng mudn gap gd nhieu ngudi va cungkhdng muln ai hdi tham
"vi hodn cdnh cita minh nhu the nen de nhay cdm, di tu di hoac budn titi, mdc
dii nhiiu khi mgi ngudi ciing chi hdi thdm vdi j tdt" Chi cho bilt, cam giac
khd chju va dau ddn nhit la 2 Jan dieu trj IVF thit bai, chj khdng chia se dugc
vdi ai, vi khdng cd ai thyc sy lang nghe va hieu cho hoan canh ciia chi.
4.3. Ap tuc ngng ne ve tdi chinh
Trong viec dieu trj hiem mudn, tai chinh la mgt vin dl rit quan trpng
cua cac cap vg chdng. Tren thuc te, cd nhieu trudng hpp ngudi benh khdng du
chi tra chp nhttng lan dieu trj hiem mupn hoac ngudi benh lam cae can thiep y
tl phitc tap. Chung tdi duge biet chi phi cho I lan diiu trj bing bien phap IVF
la rat ldn, dao ddng tit 80 trieu den hon 100 trieu hoac hon tiiy thudc vao tinh
trang siic khde va dan thudc, tiiy thudc vao cac dich vu trong benh vien ma hg
lya chpn... Tir nhirng thdng tin thu dupe cho thay, ca 3 trudng hpp deu gap khd
khan ve tai chinh, phai ddi mat vdi cam giac tieu tdn rat nhieu tien cua gia dinh
ma lai khdng ed ket qua, tir dd iinh hucmg gian tiep den vice dieu trj. Cu tbl:
Trudng hop T.: Hai vg chdng T. da tdn rat nhieu tien chtta trj de cd con.
Chdng T. lam viec budn ban cho gia dinh bdn npi, do dd ngudn thu nhap ciia
chdng bj phu thudc vao bd me. Them vao dd, viec T. nhan tien tu bd me chdng
de di chua benh, chi lai ciim thay ap lyc nang nc hon sau mdi lan dieu trj that
bai - "cam giac dd tien xudng sdng". Vi vay, de cd the tiep tuc dieu trj, T. tam

nghi dieu trj mdt thdi gian de chuan bj ve tai chinh cung nhu ve sire khde va
tam ly.
Trudng hgp H.: Vdi cdng vice la giao vien mam non, H. vua dieu tri,
nhung van phai di lam. Viec vira dam bao cdng viec, vira cd thu nhap va vua
danh thdi gian dl dieu tri hiem mudn da tao ra ap luc cho H. Chj gap khd khan
trong vice xin nghi phep dl di chtta benh, bdi neu chj nghi day thi se khdng cd
luong. Vi dieu kien khdng cho phep, chdng H. phai lo di lam nen H. phai ty di
kham chtta mdt minh, nen H. cam thay tiii than, don ddc.
Trudng hgp M.: Viec diiu trj 2 lin d 2 thanh phi ldn (chuyen tir Hd Chi
Minh ra Ha Ndi) khiln vg ching M. tin kem nhieu ve tai chinh. M. da chi
nhieu tien cho viec di lai va dieu tri. M. rai vao ndi dau mat con va sau dd la sy
nudi tiec cdng sire, tiin bac da bd ra ma khdng thanh cdng. Vdi thu nhap dua
vao luong, M. cho bilt da danh nhung ddng tiin cudi ciing de chtta trj, do dd,
neu de tiep tue dieu trj de cd con tbl phai lo ve kinh te.
Cd the thiy, cac chi phi la ganh nang vdi cac gia dinh, nhung cd le ganh
nang dd cang nang ban va gay ap lyc cho ngudi phy nu bon khi hg bj that bai,
tien ciia dd xudng sdng xuing be ma khdng dem lai lgi ich gi. Dd gidng nhu

TAP CHI TAM Vi HOC, So' 3 (252), 3 - 2020

93


that bai kep, tao ra ap luc tam ly vd cimg nang ne cho ngudi trong cudc, cam
giac nhu ngudi an hai.
5. Ban Iuan va ket luan
Tu nhung phan tich tren cho thay, diing nhu cac nghien citu da chi ra
phu nu hiem mudn va nhtrng trai nghiem trong qua trinh dieu trj hiem mudn ed
nhieu tdn thuang tam ly. Tren thuc te, dieu tri hiem mupn cd nhieu giai doan
nhu tham kham, tiem kich trirng, tao phdi, chuyen phdi... Do dd, neu ngudi

benh gap viin de d giai doan khac nhau thi lai cd nhung trai nghiem dau khd
khac nhau. Cd ngudi dau khd vi dieu trj lUI khdng thanh cdng (trudng hop H.),
cd ngudi dau khd vi chuyen phdi khdng thanh cdng (trudng hi;p T. - vi gia nhu
dugc mdt lin cd phdi thai dl cdn cd hy vpng), cd ngudi lai dau khd vi phdi thai
hinh thanh nhung lai bj hdng (trudng hgp M. vdi ndi dau ciia ba me mat con).
Do dd, ciing la sy tin thuong ve cam xiic, nhung ndi dau ciia ba ngudi phu ntt
la khac nhau. Nhung cd le, cd mdt diem ehung cua ba trudng hgp tren la cam
giac tuyet vgng: vi hp khdng hieu dugc nguyen nhan, van de ciing nam ngoai
tam kiem soat - khdng biet phai cl gang nhu the nao. Cii ba ngudi phu ntt deu
khdng biet tinh trang nay dien ra bao lau, khi nao se cd dugc con - de hg dugc
lam me. Vdi tiim the eang mong dgi, cang hy vpng, cang nd lyc de cd con
nhung lai gap that bai, khien cho sy tdn thuong cang tang len nhieu.
Ca ba trudng hgp deu hp phai chiu nhttng ap luc cua gia dinh va xa hpi dd la ap lyc sinh eon ddi vdi nha chdng (dac biet vdi tnrdng hgp H., sue khde
cia chdng binh thudng) va ngay ca khi nguyen nhan hiem mudn tit phia ngudi
chong (trudng hpp T.). Dieu nay cung cd the ly giai bdi, vdi ngudi Viet Nam,
cd con cai la mdt dieu bet site quan trpng, nen bd me chdng cua ba ngudi phy
ntt cung riit mong mdi va ap luc khi con trai hg lay vg nhieu nam ma chua sinh
dupc con (til 3 - 6 nam). Vi vay, diiu do khdng tranh khdi viec hg bj cang
thang va dieu dd dugc thi hien ra qua anh mit, gigng ndi, ngdn tu... trong giao
liep va gian tiep tao ra ap lyc cho ngudi con dSu hilm mudn. Vi du nhu vdi
trudng hpp chj T., nhieu lin me ching T. khde vl viec chj khdng sinh dugc
con - tam trang cua ba ed thi la thuong con cai, nhung cQng ed thi la sy din
vat ban than (minh da lam gi dl con bi nhu vay!) hoac dd eung cd thi la ba
thiy tlii than vi minh chua cd chau. Ben canh do, ca ba ngudi phu ntt diu bj tin
thuong bdi ldi ndi cua mgi ngudi, ma theo hg dd la tin thuang sau sic vi am
anh. Viec khat khao cd con cho thiy, con cai la mdt gia trj ldn dii vdi hp, vi
vay ca ba ngudi phu ntt deu nhay cam vdi quan niem "khdng cd con la vd gia
tri", dieu dd din den viee hg tu ti vl gia trj cua ban than.
Ngoai ra, khd khan vl tai chinh la mpt ap lyc anh hudng vua true tiip va
gian tiip din viec diiu trj hilm mudn, vi tai chinh la vin dl quyit djnh cho cac


TAP CHi TAM LV HOC, S6 3 (252), 3 - 2020


lieu trinh, cac bien phap chtta tri hiem mupn (udng thudc, bien phap lUI hoac
IVF, th$m chi la cac diiu tri phitc tap khac...). Anh hudng gian tiip la vi khdng
cd diiu kien tai chinh, nen ngudi ching phai lo di kilm tiin, ngudi vg roi vao
trang thai buin ba, cd don, khdng dugc chdng ddng hanh trong nhung lin di
diiu tri. d day, ca ba ngudi phu nu roi vao trang thai dau khd, tdn tiin vi
khdng dat kit qua (cd con), nhung ddng thdi hp cung se phai Ip ling vin dl tai
chinh chp kl hoach dieu trj tiep theo. Bdi neu ngudi benh khdng cd tiin, qua
trinh dieu tri hiem mupn se keo dai them, do dd ap lyc khdng ed con se tang
len. Them vao dd, neu keo dai them thdi gian, thi tudi ciia ngudi phu ntt se
tang len, trong khi dd, van dl tudi tac lai la mpt yeu id anh hudng din kha nang
cd con.
Cudi ciing, ba ngudi phy ntt deu roi vao tinh trang la noi dau khdng ndi
dugc ra, khdng cd ngudi dl lang nghe, chia se dl vai di nhtrng ap lyc vl tam
ly... Bdi thii nhat la xung quanh nhttng ngudi phu ntt nay, hp khdng tim dupc
ngudi thyc sy hieu de ndi ra nhttng van de ve sue khde sinh san, nhttng dau
khd va that bai trong eac lan dieu trj hiem mupn. Thir hai, ngay ea khi vdi
ngydi cd the chia se nhu vdi bd me de hoac anh chj em rupt, thi lai dieu dd lai
cimg lam cho bd me lo lang, thuong con (tham chi la cam giac bat luc). Chinh
cam xiic dd lai tao them ap lyc cho ngydi phu ntt, vi vay hp khdng the ndi ra,
khiln hg bj de nen trong tam trang.
Tdm lai, ket qua tren day mdi chi ra dupc mpt sd tdn thuong dien hinh
trong sd riit nhieu trudng hgp ngudi phu nu hiem mudn d Viet Nam - vdi khat
khao dugc lam me. Dd la cam giac gin nhu tuyet vpng, cam thay minh vd gia
trj trong mat ngudi khac va ap lyc nang ne vi tieu tdn qua nhieu tien eua ciia
gia dinh ma van khong thanh cdng.
Qua trinh dieu trj hiem mudn, vd sinh la mdt hanh trinh liiu dai, gian

nan, gay ra nhung tdn thucmg vl tam ly va nhttng tdn that ve tai chinh cho cac
cap vg chdng. Vi vay, trong tuong lai, chiing tdi se cd nhung nghien ciru dinh
lugng, tren nhieu khach the va ca d phu ntt va nam gidi, de danh gia miic do
tin thuong tam ly ciia nhttng ngudi vd sinh, hiem mudn. Ben canh dd, chiing
tdi cho rang, ben canh nhttng can thiep, dieu tri ve y hpc, hg cung can sy hd trg
ve tam ly dl duong diu tit hon tren hanh irlnh "tim con". Day ciing la nhung
ggi md cho chung tdi cho cac nghien ciru ve sau.
Tai lieu tham khao
1. Bp Y tl (2015). Hudng ddn chdn dodn vd diiu Iri cdc benh sdn phu khoa. Ban
hanh kem theo Quyit djnh sl 315/QD-BYT ngay 29/01/2015.

TAP CHI TAM Vi HOC, Sd 3 (252), 3 - 2020

95


2. Boivin J., Buntin L., Collins J.A. & Nygren K.G. (2007). International estimates of
infertility prevalence and treatment-seeking: Potential need and demand for Infertility
medical care. Human Reproduction. 22 (6). P. 1.506 - 1.512. DOI: 10.1093/humrep/
dem046.
3. Juliana Rigol Chachamovich, Eduardo Chachamovich, Helene Ezer, Marcelo P. Fleck,
Daniela Knauth & Eduardo P. Passos (2010). Investigating quality of life and healthrelated quality of life in infertility: A systematic review. Joumal of Psychosomatic
Obstetrics & Gynecology. 31 (2). P. 101 - 110.
4. Van Thj Kim Cue (2016). Ghi nhan vi ldn thuang Idm ly qua thire ti hdnh nghe vd
kinh nghiem diiu Iri chiing bdng ldi ndi. Ky yeu Hoi thao quoc te "Sang chan tam ly
va cac boat dong trg giup". NXB Dai hoc Qu()C gia. Ha Npi. Tr. 39-49.
5. Cui W. (2010). Mother or nothing- The agony of infertility. Bull World Health
Organ. 88 (12). 881-2. DOI: I0.247I/BLT.10.011210.
6. Vu Van Du (2017). Hudng ddn chdn dodn vd diiu tri sdn phu khoa. NXB Dai hpc
Quoc gia. Ha Npi.

7. Deka P.K., Sarma. S. (2010). Psychological aspects of infertility. British Journal of
Medical Practitioners. Vol. 3. No. 3. P. 32 - 34.
8. Dunkel-ScheUer C. & Lobel M. (1991). Psychological reactions lo /«/ertility. In A.
L. Stanton & C. Dunkel-Schetter (Eds.). The plenum series on stress and coping.
Infertility: Perspectives from stress and coping research. P. 29 - 57. New York. US:
Plenum Press. DOI: 10.1007/978-l-4899-0753-0_3.
9. Evers J.L. (2002). Female subfertility. Lancet. Vol. 360. P. 151 - 159. DOI: 10.1016/
80140-6736(02)09417-5.
10. Esther Giller. (1999). The annual conference of the maryland mental hygiene
administration. Passages to Prevention; Prevention across Life's Spectrum.
11. Goker A., Yanikkerem E., Birge O. & Kuscu N.K. (lOM). Quality of life in
Turkish infertile couples and related factors Human Fertility. 21 (3). P. 195 - 203. DOI:
10.1080/14647273.2017.1322223.
12. Ngay dang 05/04/2018.
13. Jafarzadeh-Kenarsari p., Ghahiri A., Zargham-Boroujeni A., Habibi M. (2015).
Exploration of the counseling needs of infertile couples: A qualitative study. Iranian
Joumal of Nursing and Midwifery Research 20 (5). P. 552 - 559. DOI: 10 4103/
1735-9066.164506.
14. Jones E. & Wessely S. (2006). Psychological trauma: A historical perspective
Psychiatry. 5 (7). P. 217 - 220. DOI: 10.1053/j.mppsy.2006.04.011.
15. Lalos A. (1999). Breaking bad news concerning fertility. Human Reproduction
Vol. 14. Iss. 3. P. 581 - 585. DOI: 10.1093/humrep/14.3.581.
96

TAP CHI TAM Lt HOC, SO' 3 (252), 3 - 2020


16. Lee T.Y. & Sun G.H. (2000). Psychological respones of Chinese infertile husbands
andwives. Archives of Andrology. Vol. 45. P. 143 - 148.
17. Maya N. Mascarenhas, Seth R. Flaxman, Ties Boerma, Sheryl Vanderpoel,

Gretchen A. Stevens (2012). National, regional, and global trends in infertility
prevalence since 1990: A systematic analysis of 277 health surveys. PLOS Medicine.
Openaccess. Vol. 9. Iss. 12. P. 1 - 12. DOI: 10.1371/journal.pmed.l001356.
18. Menning B.E. (1980). The emotional needs of infertile couples. Fertility and
Sterility. Vol. 34. Iss. 4. P. 313 - 319. DOI: 10.1016/S0015-0282(16)45031-4.
19. Nguyen D6 H6ng Nhung, Nguyin Do Huong Giang (2017). Nhu cdu chdm sdc
sire khoe ldm than a ngudi vd sinh (Nghien cuu Irudng hgp lgi khoa Hd trg sinh sdn,
Benh vien A Thdi Nguyen). Ky yeu Hpi thao Quoc te Tam ly hoc khu vuc Dong Nam
A lan thu nhat "'Hanh phuc eon nguoi va su phat trien ben vung". NXB Dai hoc Qu6c
gia. Ha Noi. Tr. 70 - 77.
20. Nguyen Thi Hang Phuang (2011). Thdi do xd hdi vi hiim miidn/vd sinh: Thuc
trgng vd cdch irng phd cua ngudi phu nu. Ky yeu Hpi ihao Qu6c t£: 20 nam Khoa Xa
hoi hpc, Trucmg Dai hoc Khoa hpc Xa hpi va Nhan van. NXB Dai hoc Quoc gia. Ha
Npi. Tr. 350-358.
21. Nguyen Thi Hang Phuong (2011). Thuc trgng Idn thuang Idm ly a phu nif hiem
mugn/vd sinh. Tap chi Nghien cim Gia dinh va Gioi. So 1. Tr. 68 - 80.
22. Rutstein, Shea O. and Iqbal H. Shah (2004). Infecundily, infertility, and
childlessness in developing countries. DHS Comparative Reports No. 9. Calverton.
Maryland, USA: ORG Macro and the World Health Organization.
23. Huynh Van Son (2019). Tdn thuang Idm ly ciia Ire em trong gia dinh khong todn
ven. Tap chi Tam ly hpc. So 6. Tr. 29 - 40.
24. Tir diin Y hgc Anh - Viel (2007). NXB Tu diSn Bach Khoa. Ha Npi.
25. Nguyen Due Vy (chu bien, 2006). Bdi gidng sdn phu khoa dung cho sau dgi hgc.
Bp mon Phu san, Truong Dai hpc Y Ha Npi.
26. World Health Organization (2005). Malawi demographic and health survey 2004.
Malawi National Statistical Office.

TAP CHI TAM LV HOC, So' 3 (252), 3 - 2020

97