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Crawshaw M, Pericleous-Smith A, Dark S. Counselling challenges associated with donor conception and surrogacy treatments - time for debate. HUM FERTIL 2022; 25:806-812. [PMID: 34240666 DOI: 10.1080/14647273.2021.1950850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Fertility counselling services have had to respond to significant developments in fertility treatments in recent years, prompting increasingly complex personal and professional ethical challenges. This Commentary focuses on those rising from donor conception and/or surrogacy. The profile of those seeking such treatments has changed to include growing numbers of same sex couples, single people, people who are transitioning or have done, people seeking posthumous use of gametes, and people using cross-border services. Alongside, awareness has grown of life-span implications, the impact of commercial DNA testing, and the need for 'later-life' support. Responses vary internationally and the time for debate is overdue. Who should provide fertility counselling and how? Should specialist qualifications, training, continuing professional development, and regulation be required? Should counsellors play a role in assessing suitability to parents? What aspects of different contractual arrangements and conflicts of interest need attention? Has the time come for counselling to be mandatory as part of pre-treatment pathways? What should be the relationship between fertility counsellors and multi-disciplinary clinic teams? How might fertility counsellors be represented nationally and internationally? What should be their relationship to 'later life' professional support? What place should professional knowledge hold in the evidence base?
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Affiliation(s)
- Marilyn Crawshaw
- Department of Social Policy & Social Work, University of York, York, UK
| | | | - Suzanne Dark
- Jessop Fertility, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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Caputo A, Langher V, Capri O, Muzii L, Fedele F. The need to restore generative identity in women undergoing assisted reproductive technology: Development and psychometric validation of the fertility reparation inventory. J Clin Psychol 2021; 78:1151-1169. [PMID: 34735723 PMCID: PMC9298421 DOI: 10.1002/jclp.23273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/17/2021] [Indexed: 11/29/2022]
Abstract
Objective This study described the development and psychometric evaluation of the fertility reparation inventory, providing measures of manic and expiatory reparation as symbolic dynamics of restoring one's procreative and generative identity through Assisted Reproductive Technology (ART). Methods Two cross‐sectional studies were conducted on female patients undergoing ART (N = 150) and women from the general population (N = 250), respectively. Exploratory factor analysis and confirmatory factor analysis assessed construct validity and reliability. Pearson's bivariate correlations were used to provide convergent evidence of validity with omnipotence, perceived infertility‐related stress, anxiety, depression, need for reparation, fear of punishment, and hope. Results The results confirmed a two‐factor solution of the 12‐item instrument, with adequate fit, a very good internal consistency, and well‐supported forms of convergent validity. Conclusion This study provides a meaningful psychodynamic contribution, in both theoretical and empirical terms, for the understanding of emotional dynamics and psychological issues underlying the demand for ART.
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Affiliation(s)
- Andrea Caputo
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Viviana Langher
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Oriana Capri
- Sterility and Assisted Reproduction Unit, Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Ludovico Muzii
- Sterility and Assisted Reproduction Unit, Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Fabiola Fedele
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
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Pericleous-Smith A, Dark S, McCluskey G, Mizen L, Crawshaw M. Survey of fertility counselling provision in UK licensed treatment centres during the first phase of the COVID-19 pandemic. HUM FERTIL 2021:1-11. [PMID: 33749479 DOI: 10.1080/14647273.2021.1898053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A survey of UK fertility counsellors' experiences of the impact on their service, including its availability, during the first phase of the COVID-19 pandemic in the spring of 2020 received 64 responses. Fifty three respondents had continued to provide a service. Forty now worked from a wholly/substantially different location to normal but many clinics provided no practical support for this (n = 17), or remote access to relevant clinic (n = 17) or client information (n = 12) and twenty five respondents reported reduced multi-disciplinary involvement. Few received regular information updates. Some whose service was stopped (n = 11) abruptly lost income and/or were unsure whether they could or would resume working. Increased remote counselling proved crucial for accessibility and could be effective. Concerns included fatigue, technical and practical challenges, confidentiality, lowered therapeutic effectiveness. Respondents supported patients having choice over how to receive counselling in the future but a third (n = 21) had not been included in such planning. These findings suggest the need for increased involvement and support of fertility counsellors in the event of a future waves, other pandemic or healthcare crisis. More needs to be understood about why clinic responses varied; how to improve the safety and efficacy of remote counselling; and how to accommodate future needs for face-to-face contact.
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Affiliation(s)
| | - Suzanne Dark
- Jessop Fertility, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | | | - Lynda Mizen
- Wales Fertility Institute, Neath Port Talbot Hospital, Swansea, UK
| | - Marilyn Crawshaw
- Department of Social Policy and Social Work, University of York, York, UK
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Fedele F, Caputo A, Cordella B, Muzii L, Pietrangeli D, Aragona C, Langher V. What About Fertility Staff Emotions? An Explorative Analysis of Healthcare Professionals' Subjective Perspective. EUROPES JOURNAL OF PSYCHOLOGY 2020; 16:619-638. [PMID: 33680202 PMCID: PMC7909494 DOI: 10.5964/ejop.v16i4.2245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/24/2020] [Indexed: 11/29/2022]
Abstract
Infertility-related psychological research is traditionally oriented to analyze the wellbeing of couples undergoing Assisted Reproductive Technologies (ART), than to study the job-related effects on the healthcare fertility staff. This piece of research aims at understanding the subjective perspective of the fertility professionals and contribute to identify their emotional dynamics in their work environment. An in-depth explorative research study was conducted on 12 healthcare professionals of an Italian ART hospital clinic. Structured interviews with open-ended questions were administered to explore their deep feelings about their professional experience. Emotional text analysis was then conducted to analyze the textual corpus of their narratives to grasp their affective symbolizations. Statistical multidimensional techniques were used to detect some thematic domains (cluster analysis) and latent factors organizing the contraposition between them (multiple correspondence analysis). Five thematic domains were detected which refer to different emotional dimensions, as follows: performance anxiety (Cluster 1), ambivalence between omnipotence and powerlessness (Cluster 2), care burden (Cluster 3), feeling of duty (Cluster 4), and sense of interdependence (Cluster 5). Then, four latent factors were identified dealing with the laborious attempt to remedy, the realistic sense of limitation, the incumbent feeling of pressure and the restorative sense of justice, respectively. The results are discussed based on the existing literature and some useful recommendations for staff education, training and clinical supervision are provided accordingly.
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Affiliation(s)
- Fabiola Fedele
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Barbara Cordella
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Ludovico Muzii
- Department of Gynecologic-Obstetrical and Urologic Sciences, “Sapienza” University of Rome, Umberto I Hospital, Rome, Italy
| | - Daniela Pietrangeli
- Department of Gynecologic-Obstetrical and Urologic Sciences, “Sapienza” University of Rome, Umberto I Hospital, Rome, Italy
| | - Cesare Aragona
- Department of Gynecologic-Obstetrical and Urologic Sciences, “Sapienza” University of Rome, Umberto I Hospital, Rome, Italy
| | - Viviana Langher
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
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Adelosoye AA, Fasipe OJ, Medunoye EI, Adelosoye OC, Sunday EO. Assessment of family function impact on depression severity among infertile women attending a teaching hospital in South-South Nigeria. Future Sci OA 2020; 6:FSO595. [PMID: 32983563 PMCID: PMC7491040 DOI: 10.2144/fsoa-2020-0033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/07/2020] [Indexed: 11/23/2022] Open
Abstract
AIM Family function and husband support can impact depression severity in women with infertility disorder. The aim of this study was to assess the impact of family function and husband support on depression severity among women with infertility disorder at the fertility clinics of a University Teaching Hospital, South-South, Nigeria. METHODOLOGY A cross-sectional descriptive study was carried out among 341 female respondents attending the University of Benin Teaching Hospital fertility clinics over a 3-month period, using a semistructured interviewer administered questionnaire. Data obtained were analyzed. RESULT Respondents mean age was 36 ± 5.3 years. The overall prevalence for depression in this study was 42.5% with a breakdown of 64.2%, 30.4% and 5.4% of these depressed participants having mild, moderate and severe depression, respectively. Family dysfunction had a statistically significant relationship with severity of depression in women with infertility (p < 0.001). A statistically significant relationship was established between poor husband support and the severity of depression (p < 0.001). CONCLUSION Depression is highly prevalent among women with infertility disorder, severe depression was associated with family dysfunction. Good family function would reduce the severity of depression.
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Affiliation(s)
- Alex A Adelosoye
- Department of Family Medicine, University of Medical Sciences Teaching Hospital Complex, Ondo City, Ondo State, Nigeria
| | - Olumuyiwa J Fasipe
- Department of Clinical Pharmacology & Therapeutics, Faculty of Basic Clinical Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
| | - Elihu I Medunoye
- Department of Family Medicine, University of Medical Sciences Teaching Hospital Complex, Ondo City, Ondo State, Nigeria
| | - Onyekachukwu C Adelosoye
- Department of Anaesthesiology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | - Elisha O Sunday
- Department of Clinical Pharmacology & Therapeutics, Faculty of Basic Clinical Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
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Logan S, Anazodo A. The psychological importance of fertility preservation counseling and support for cancer patients. Acta Obstet Gynecol Scand 2019; 98:583-597. [DOI: 10.1111/aogs.13562] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 01/29/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Shanna Logan
- School of Women and Children's Health Faculty of Medicine University of New South Wales – Sydney Kensington NSW Australia
- Kids Cancer Center Sydney Children's Hospital Randwick NSW Australia
- Fertility& Research Center Royal Hospital for Women Randwick NSW Australia
| | - Antoinette Anazodo
- School of Women and Children's Health Faculty of Medicine University of New South Wales – Sydney Kensington NSW Australia
- Kids Cancer Center Sydney Children's Hospital Randwick NSW Australia
- Nelune Comprehensive Cancer Center Prince of Wales Hospital Randwick NSW Australia
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Seymenler S, Siyez DM. İnfertilite Psikolojik Danışmanlığı. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2018. [DOI: 10.18863/pgy.358095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
When intended parents choose to have donor sperm treatment (DST), this may entail wide-ranging and long-lasting psychosocial implications related to the social parent not having a genetic tie with the child, how to disclose donor-conception and future donor contact. Counselling by qualified professionals is recommended to help intended parents cope with these implications. The objective of this study is to present findings and insights about how counsellors execute their counselling practices. We performed a qualitative study that included 13 counsellors working in the 11 clinics offering DST in the Netherlands. We held a focus group discussion and individual face-to-face semi-structured interviews, which were fully transcribed and analysed using thematic analysis. The counsellors combined screening for eligibility and guidance within one session. They acted according to their individual knowledge and clinical experience and had different opinions on the issues they discussed with intended parents, which resulted in large practice variations. The counsellors were dependent on the admission policies of the clinics, which were mainly limited to regulating access to psychosocial counselling, which also lead to a variety of counselling practices. This means that evidence-based guidelines on counselling in DST need to be developed to provide consistent counselling with less practice variation.
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Affiliation(s)
- Marja Visser
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Trudie Gerrits
- Faculty of Social and Behavioral Sciences, Sociology and Anthropology, University of Amsterdam, Amsterdam, The Netherlands
| | - Fulco van der Veen
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique Mochtar
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
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Shreffler KM, Greil AL, McQuillan J. Responding to Infertility: Lessons From a Growing Body of Research and Suggested Guidelines for Practice. FAMILY RELATIONS 2017; 66:644-658. [PMID: 29422703 PMCID: PMC5798475 DOI: 10.1111/fare.12281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Infertility is a common, yet often misunderstood, experience. Infertility is an important topic for family scientists because of its effects on families; its relevance to research in related areas, such as fertility trends and reproductive health; and its implications for practitioners who work with individuals and couples experiencing infertility. In this review, we focus on common misperceptions in knowledge and treatment of infertility and highlight insights from recent research that includes men, couples, and people with infertility who are not in treatment. The meaning of parenthood, childlessness, awareness of a fertility problem, and access to resources are particularly relevant for treatment seeking and psychosocial outcomes. On the basis of insights from family science research, we provide specific guidelines for infertility practice within broader social contexts such as trends in health care, education, employment, and relationships. Guidelines are presented across three areas of application: infertility education for individuals, families, and practitioners; steps to support the emotional well-being of those affected by infertility; and understanding of treatment approaches and their implications for individuals and couples.
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Role of the mental health professional in education and support of the medical staff. Fertil Steril 2015; 104:271-6. [PMID: 26056926 DOI: 10.1016/j.fertnstert.2015.05.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 11/23/2022]
Abstract
This review argues that mental health professionals are underutilized in the reproductive health care system. Counselors in the field of reproductive medicine could broaden their care from a strictly one-on-one patient care perspective to a more integrated and collaborative approach that also involves education, training, and support of the fertility clinic staff. The literature has shed light on reasons for patient discontinuation, but little is known about staff burnout in reproductive health care, and even less has been done to address work-related stress, job dissatisfaction, and poor emotional and physical health among fertility clinic staff. Specific educational strategies and training techniques are addressed to help reduce staff stress, prevent burnout, and improve overall patient care.
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Peterson B, Boivin J, Norré J, Smith C, Thorn P, Wischmann T. An introduction to infertility counseling: a guide for mental health and medical professionals. J Assist Reprod Genet 2012; 29:243-8. [PMID: 22290604 DOI: 10.1007/s10815-011-9701-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 12/22/2011] [Indexed: 11/26/2022] Open
Abstract
The practice of infertility counseling delivered by mental health and medical professionals has become more sophisticated and widespread over the past decade. This paper summarizes information presented at the second campus workshop of the Special Interest Group of Psychology and Counseling of the European Society of Human Reproduction and Embryology (ESHRE). This group is dedicated to improving infertility services by creating meaningful connections between mental health and medical professionals. The paper identifies key issues that infertility counselors must consider in their work with couples experiencing infertility. The use of supportive psychosocial interventions and treatments are highlighted. The paper also details the process for choosing the most appropriate type of infertility counseling, and the use of assessment tools that assist in understanding infertility related symptoms. Infertility counselors should also consider gender differences, the impact of infertility on a couple's sexual relationship,and the unique challenges couples face regarding third-party conception. Finally, the paper addresses specific recommendations for infertility counselors in mental health and medical settings.
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Affiliation(s)
- Brennan Peterson
- Faculty of Psychology, Crean School of Health and Life Sciences, Chapman University, One University Drive, Orange, CA 92866, USA.
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Van den Broeck U, Emery M, Wischmann T, Thorn P. Counselling in infertility: individual, couple and group interventions. PATIENT EDUCATION AND COUNSELING 2010; 81:422-428. [PMID: 21075589 DOI: 10.1016/j.pec.2010.10.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Revised: 10/01/2010] [Accepted: 10/06/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Infertility is considered a biopsychosocial crisis and infertility counselling is recommended as an integral part of a multidisciplinary approach. This article will outline the theoretical background and describe common interventions used in infertility counselling for individuals, couples and in a group setting. METHODS This article summarizes the proceedings of the first campus workshop of the Special interest group of Psychology and Counselling of the European Society for Human Reproduction and Embryology (ESHRE). RESULTS Infertility counselling offers the opportunity to explore, discover and clarify ways of living more satisfyingly and resourcefully when fertility impairments have been diagnosed. The Heidelberg Fertility Consultation Service is presented as a framework for individual and couples counselling and highlights important issues in counselling patients. For group work a number of steps to set up a group within an infertility framework are discussed. CONCLUSION In recent years, infertility counselling has become a specialist form of counselling requiring professional expertise and qualification. Key issues and common interventions are presented to raise awareness for the specific counselling needs of individuals and couples experiencing infertility and undergoing medical treatment. PRACTICE IMPLICATIONS Mental health professionals new to the field of reproductive technologies as well as those in other areas of mental health counselling clients with fertility disorders can benefit from the topics addressed.
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Affiliation(s)
- Uschi Van den Broeck
- University Hospital Gasthuisberg, Leuven University Fertility Centre (LUFC), Herestraat 49, B-3000 Leuven, Belgium.
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