Couple satisfaction with overall sub-fertility management:a questionnaire based study

Bapir M, Hoh J, Brown J & Al-Inizi SDepartment of Women Health, South Tyneside District HospitalHarton Lane, South Shields, United Kingdom

IntroductionInfertility is an upsetting and stressful experience for some women 1,2, therefore access to support group and psychological counselling would be beneficial at all stage of infertility treatment and investigation 3,4.

Objectives- To assess satisfaction of sub-fertile couples with the overall management of infertility.- To assess the couples expectation in the term of clinical care and emotional aspect of sub-fertility starting pre-assessment nurse led clinic to fifth fertility clinic appointment.

Design

Questionnaire based study.

MethodsAnonymous questionnaires were handed to couples at the end of the first nurse specialist assessment clinic, first appointment clinic and at the 5th appointment fertility clinic at Women Health Unit at South Tyneside Hospital.

PopulationA total of 111 women with history of sub-fertility were invited to participate in this study.

Pre-assessment led clinic 61

First fertility clinic appointment 31

Fifth fertility clinic appointment 19

ResultsPre-Assessment Nurse Led Clinic

100% of couples were satisfied that the sub-fertility nurse answered all their concerns and questions. Also 100% of couples were satisfied with the way the information provided by the sub-fertility nurse.

Couples satisfaction with the nurse explanation of sub-fertility investigations

Blood test

Tubal patency tests

Semen analysis

Satisfied 100% 78.69% 91.8%

Not Satisfied 8.2% 1.64%

Unsure 13.1% 6.6%

16.40% of couples felt anxious at this clinic and worried about the expectations.

Average of overall satisfaction with this nurse led pre-assessment visit in a scale of 1-10 is 9.67.

first and fifth fertility clinic visits

96.8% of couples were satisfied with the doctor’s explanation of the sub-fertility investigation results.

1st Visit 5th Visit

Couples satisfied that the doctor has reduced their anxiety and answered most of their queries

96.8% 94.74%

Couples satisfied with the doctor’s attitude 94.74%

Couples satisfaction with the information and options discussed with them by the doctor at first and fifth clinic visits

Couples satisfaction with the explanation givento them regarding drug treatment and possible

risks and side effects of treatment

More than half of the couples were worried about theirfuture fertility and that they may not have a successful

treatment which may require referral for IVF

Majority of couples were not anxious at thisclinic or worried about the expectations

16% at first visit and 10.5% at fifth visit couplespreferred to see an infertility psychological counsellor

as part of the infertility service at this clinic

45.2% at first visit and 73.68% at fifth visit couples felt that written information is needed to cover the

information required for drug treatment in sub-fertility

Couples overall satisfaction with the 1st and 5th visits in a scale of 1-10 are 8.8 and 9.2 consecutively.

Conclusion

Couples were satisfied with their care, especially as the service is a couple-centred approach. The results of the 1st and 5th follow up clinic questionnaires have indicated that the involvement of an infertility psychological counsellor could further improve the service.

References1- Freeman EW, Boxer AS, Rickels K, Tureck R, Mastroianni L. Psychological evaluation and support in a program of in vitro fertilization and embryo transfer. Fertil Steril 1985;43:48–53.

2- Newton CR, Hearn MT, Yuzpe AA. Psychological assessment and follow-up after in vitro fertilization: assessing the impact of failure. Fertil Steril 1990;54:879–86.

3- Domar AD, Zuttermeister PC, Friedman R. The psychological impact of infertility: a comparison with patients with other medical conditions. J Psychosom Obstet Gynaecol 1993;14 Suppl:45–52.

4- Domar AD, Clapp DE. Impact of group psychological interventions on pregnancy rates in infertile women. Fertil Steril 2000;73:805–11.

Acknowledgment: The authors would like to thank the couples participated in this study and a special thanks to J. Brown the specialist sub-fertility nurse.