IVF is an emotional process. Most patients envision their whole lives that they'll become pregnant at their own pace, and working with a fertility clinician is far from their first choice to build their families. It can even induce feelings of failure.
When patients begin the IVF process, they expect warmth and sensitivity from their reproductive endocrinologist. However, due to witnessing unsuccessful cycles and miscarriages on a regular basis, some physicians avoid becoming emotionally attached to patient success. But patient sensitivity is a key component of successful doctor-patient relationships.
As a clinician, being more empathetic and less clinically detached with patients who are undergoing IVF will lead to better patient experiences, even if the outcome of the process itself is not a success.
Act as a Partner
A study published in EphMRA that explored what patients expect from their reproductive endocrinologists found that the first expectation of many prospective parents in the United States is that their doctor will act as a partner in their infertility journey.
Patients want to be included as a member of their treatment team. This means communicating openly, being honest but compassionate about difficult outcomes, and inviting patients' opinions and input. Rather than dictating a treatment plan, provide practical help and explanations, such as why certain procedures are necessary.
Being a good partner means sharing knowledge and taking time to listen. A survey by the Society for Participatory Medicine found that doctors who practice good listening create more positive patient experiences.
A key pillar of patient sensitivity is acknowledging cultural and moral beliefs. During initial consultations, ask patients about any ethical qualms they may have with the IVF process and explain how success might still be possible while honoring these preferences. At the same time, recognize any implicit biases you may have and set them aside when partnering with patients.
Explain Fertility Treatments
Rather than asking your patients to trust you implicitly, prioritize patient education and two-way communication. Patients should never be left wondering why certain treatments are recommended or what clinical terminology means.
With patients undergoing IVF treatments for the first time, it is imperative to explain specific protocols step by step, including why the protocol is recommended and what patients can realistically expect. Although success can never be guaranteed, patients will have more faith in the process when they feel informed and are included in treatment conversations. When possible, offer support group suggestions and outside resources to further ease patient anxiety.
Respond to IVF Failures With Empathy
The only outcome patients want from IVF is a pregnancy that results in a live birth. When an IVF cycle fails, they will look to you for support and answers. Rather than withdraw emotionally after an IVF cycle fails, respond with empathy and compassion.
Explain what was encouraging — for example, the embryo was genetically normal, despite not implanting — and why the cycle might have failed. Outline what changes could be made to promote the odds of future success, but keep in mind that managing expectations is also crucial at this stage.
Consider the Mental Health of Patients
It is critical to recognize when patients need to take a step back from the IVF process to address their mental health. A study published in Fertility and Sterility found that at fertility clinic appointments, a majority of women and about one-third of men exhibited depression, and a majority of both women and men exhibited anxiety. Unfortunately, most patients in the study were not referred to a mental health professional.
If your clinic does not have a counselor on staff, be prepared to offer recommendations to local providers.
Educate Staff Members
It is not enough for you to deal with patients' emotional needs in a sensitive way — everyone at your fertility clinic must do the same. Provide regular training to new and veteran staff members about patient expectations and interpersonal communication. Remember that your patients' perception of their experience is comprised of interactions with both you and the rest of your staff. Coming across as approachable and accessible to patients in need is also important. If possible, offer an online portal or have someone on call to field nonemergency questions 24/7.
