In September 2015 Merrion Fertility Clinic (MFC) decided to embark on a pilot project, setting up a Patient Support Group offering support to patients through what can be a complex journey towards parenthood.

The purpose of the programme is to facilitate patients to come together with the common objective of offering each other support and sharing their experiences in a safe and confidential environment.

The support group allows for a maximum of 10 patients in any one session and is run by MFC’s Fertility Counsellor, Kay Duff.  Kay has been in private practise as a counsellor, supervisor and facilitator since 1993.  She trained and worked for 10 years with Relationship Ireland as a Couple’s counsellor, coming to the area of Fertility in 2003 as the attending counsellor with the Merrion Fertility Clinic.

The feedback from the meetings has been extremely positive and the Support Group is now a permanent free service provided to MFC patients.  Over the last two years over 172 patients have attended the group, with 36 of those attending more than once.

  1. Background

The World Health Organisation (WHO) define infertility as: “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”

It is a medical condition that can affect people of any age and has a potentially devastating effect on people’s lives. The WHO defines Reproductive health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and its functions and processes”. 

Most patients are able to cope with the demands associated with infertility and fertility treatment. However, studies show that one in five of patients experience significant distress.  International fertility groups such as ESHRE (European Society of Human Reproduction and Embryology) recommend that doctors and clinics should try to help patients identify their level of stress and provide appropriate help to those who need it.

In September 2014 the General Manager at MFC commenced a Masters Degree in Quality and Safety in Healthcare with the Royal College of Surgeons Ireland.  Her dissertation focused on the patient’s perspective on quality in assisted reproduction and the growing importance of patient centered care (PCC).

Her literature review highlighted the importance of patient outcomes other than those related to pregnancy and safe practice, in particular with regard to the psychological impact of fertility treatment.

Boivin identified five paradigm shifts in the evolution of the role of psychology and counselling in infertility.  The most recent shift refers to the realisation that compliance with protracted fertility treatment is largely dependent on the adoption of ‘integrated’ fertility care through patient involvement.  This reinforces the importance of measuring patient outcomes in a quality service and patient centered care (Boivin & Gameiro, 2015).

Gameiro et al specifically looked at why couples discontinue treatment, despite the fact that the chance of achieving pregnancy eventually is over 70%.  Their article concludes that this is largely due to the fact that fertility services fail to manage the ‘burdens of fertility’ (S Gameiro, Boivin, Peronace, & Verhaak, 2012).

In 2013 they delved further into the burdens on patients undergoing ivf, in particular their vulnerability and negative staff interactions, and concluded that future services should place more emphasis on managing and or eliminating these burdens, reinforcing their conclusions in 2012 (Sofia Gameiro, Boivin, & Domar, 2013).

Gameiro in later work looked specifically at whether or not the dimensions of patient centered cared were directly associated with better well-being.  He concluded that there was a relationship.  Over all his research reinforces role of PCC (Sofia Gameiro, Canavarro, & Boivin, 2013).

  1. Effect on organisation

This project has resulted in MFC providing free counselling services to patients whilst providing optimal value for money.  It has allowed MFC to provide a more holistic and patient centred service to our patients in line with the evidence outlined in the research.

The most significant impact however has been experienced by our patients, as evidenced in the group feedback forms.