Patient Counseling about Infertility

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Patient Counseling about Infertility

• Association of Reproductive Health Professionals
• www.arhp.org

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Learning Objectives

• Recognize common emotional responses to
  infertility.
• Utilize effective counseling strategies for
  individuals and couples facing infertility.
• List additional resources for patient information
  about infertility.

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Basic Services for Infertile Couples
2. Conduct appropriate diagnostic workup
Stewart GK. 1998
4
Pregnancy with Appropriate Treatment
Couples achieving pregnancy with treatment
Morell V. Primary Care. 1997.
5
Emotional Responses to Infertility
Harkness C. The Infertility Book. 1992
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Emotional Impact on Couple

• Isolation
• Stress
• Anger
• Self-consciousness
• Inability to talk to others
• Marital dissatisfaction

Cousineau TM, Domar AD. Best Pract Res Clin
Obstet Gynaecol. 2007. Monga M, et al. Urology.
2004.
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Mens Reactions to Infertility

• Loss
• Stigma
• Low self-esteem
• Inadequacy
• Failure

Glover L, Abel PD, Gannon K. Br J Clin Psychol.
1998. Throsby K, Gill R. Men and Masculinities.
2004. Webb RE, Daniluk JC. Men and Masculinities.
1999.
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Womens Reactions to Infertility


women carry the psychological burden of
infertility, even when the reproductive
impairment lies with the husband.
Abbey A, Andrews FM, Halman LJ. Psychol Women Q.
1991. Cousineau TM, Domar AD. Best Pract Res Clin
Obstet Gynaecol. 2007.
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Women Feel Isolated by Infertility

• Preoccupation
• Criticism
• Jealousy
• Guilt
• Low self-worth
• Depression

Cousineau TM, Domar AD. Best Pract Res Clin
Obstet Gynaecol. 2007. Domar AD, Seibel MM.
1997. Greil A. Not yet pregnant Infertile
couples in contemporary America.1991.
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Fears Related to Infertility

• Medical aspects
• Relationship effects
• Uncertainty of treatment outcomes

Harkness C. The Infertility Book. 1992.
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Other Difficulties Caused by Infertility

• Discomfort, embarrassment
• Intrusiveness of treatment
• Financial costs
• Changing life plans
• Pressures on sex life
• Time commitment

Harkness C. The Infertility Book. 1992.
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Issues Couples Will Face


Nearly every infertile couple will encounter
some problem with divergent cultural perspectives
and expectations, communication, sexuality, and
decision-makingissues that often arise
unexpectedly and sometimes simultaneously.
Harkness C. 1992
Harkness C. The Infertility Book. 1992
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Provider Support Is Important

• Assess stress and well-being
• Provide information, referrals
• Establish open communication

more
Bruckner PS, McKenry PC. J Obstet Gynecol
Neonatal Nurs. 2004. Cousineau TM, Domar AD. Best
Pract Res Clin Obstet Gynaecol.
2007. Whitman-Elia GF, Baxley EG. J Am Board Fam
Pract. 2001.
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Provider Support Is Important (continued)

• Some patients expect provider to take total
  responsibility
• Some fear offending provider

Bruckner PS, McKenry PC. J Obstet Gynecol
Neonatal Nurs. 2004. Cousineau TM, Domar AD. Best
Pract Res Clin Obstet Gynaecol.
2007. Whitman-Elia GF, Baxley EG. J Am Board Fam
Pract. 2001.
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Referrals for Infertility Patients

• Counseling
• Support groups
• Advocacy organizations

Cousineau TM, Domar AD. Best Pract Res Clin
Obstet Gynaecol. 2007. Whitman-Elia GF, Baxley
EG. J Am Board Fam Pract. 2001.
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Additional Resources

• American Society for Reproductive Medicine
  www.asrm.org/search/providersearch.html
• RESOLVE www.resolve.org
• State, county, and local medical societies