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The needs of subfertile couples continuing to attempt natural conception: in-depth interviews
STUDY QUESTION: What are the experiences and the support and sexual advice needs of subfertile couples continuing to attempt natural conception after the diagnostic fertility work-up? SUMMARY ANSWER: Exploration of the experiences of couples showed that couples would have appreciated fertility clini...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479888/ https://www.ncbi.nlm.nih.gov/pubmed/36134038 http://dx.doi.org/10.1093/hropen/hoac037 |
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author | Dreischor, Felicia Laan, Ellen T M Peeters, Fleur Peeraer, Karen Lambalk, Cornelis B Goddijn, Mariëtte Custers, Inge M Dancet, Eline A F |
author_facet | Dreischor, Felicia Laan, Ellen T M Peeters, Fleur Peeraer, Karen Lambalk, Cornelis B Goddijn, Mariëtte Custers, Inge M Dancet, Eline A F |
author_sort | Dreischor, Felicia |
collection | PubMed |
description | STUDY QUESTION: What are the experiences and the support and sexual advice needs of subfertile couples continuing to attempt natural conception after the diagnostic fertility work-up? SUMMARY ANSWER: Exploration of the experiences of couples showed that couples would have appreciated fertility clinic staff embedding expectant management into the fertility clinic trajectory, supportive staff with female and male patient interactions and advice on common experiences of peers and on managing their lifestyle, distress and subfertility-related sexual challenges. WHAT IS KNOWN ALREADY: Dutch and British professional guidelines advise newly diagnosed subfertile couples with a ‘good prognosis’ to continue to attempt natural conception and do not require fertility clinic staff to interact with patients. Fertility clinic staff and subfertile couples struggle to follow these guidelines as they feel an urgent need for action. Subfertile couples might benefit from sexual advice, as subfertility is negatively associated with sexual functioning, which is important for natural conception. STUDY DESIGN, SIZE, DURATION: Twelve one-time in-depth interviews (2015–2017) were conducted with 10 heterosexual couples and 2 women whose partners did not participate, then the interviews were subjected to inductive content analysis, reaching inductive thematic saturation. PARTICIPANTS/MATERIALS, SETTING, METHODS: The 22 interviewees had experienced 3–18 months of expectant management after their diagnostic fertility work-up in a Belgian or a Dutch tertiary fertility clinic. The face-to-face in-depth interviews explored positive and negative experiences and unmet needs. The transcribed interviews were subjected to inductive content analysis, by two researchers discussing initial disagreements. MAIN RESULTS AND THE ROLE OF CHANCE: Couples would appreciate fertility clinic staff embedding expectant management in the fertility clinic trajectory, by starting off with reassuring couples that their very thorough diagnostic fertility work-up demonstrated their good chance of natural conception, and by involving couples in deciding on the duration of expectant management and by planning the follow-up appointment after expectant management up front. Couples had encountered sexual challenges during expectant management and had an interest in sexual advice, focused on increasing pleasure and partner bonding and preventing the rise of dysfunctions. The couples agreed that a (secured) website with evidence-based, non-patronizing text and mixed media would be an appropriate format for a novel support programme. Couples were keen for interactions with fertility clinic staff which addressed both partners of subfertile couples. Couples also valued advice on managing their lifestyle and distress and would have liked information on the experiences of their peers. LIMITATIONS, REASONS FOR CAUTION: Recall bias is plausible given the retrospective nature of this study. This explorative interview study was not designed for examining country or gender differences in experiences and needs but it did generate new findings on inter-country differences. WIDER IMPLICATIONS OF THE FINDINGS: Rather than simply advising expectant management, fertility clinics are encouraged to offer couples who continue to attempt natural conception after their diagnostic fertility work-up, supportive patient–staff interactions with advice on common experiences of peers and on managing their lifestyle, distress and sexual challenges related to subfertility. STUDY FUNDING/COMPETING INTEREST(S): Funded by Flanders Research Foundation and the University of Amsterdam. There are no competing interests. TRIAL REGISTRATION NUMBER: N/A. |
format | Online Article Text |
id | pubmed-9479888 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-94798882022-09-20 The needs of subfertile couples continuing to attempt natural conception: in-depth interviews Dreischor, Felicia Laan, Ellen T M Peeters, Fleur Peeraer, Karen Lambalk, Cornelis B Goddijn, Mariëtte Custers, Inge M Dancet, Eline A F Hum Reprod Open Original Article STUDY QUESTION: What are the experiences and the support and sexual advice needs of subfertile couples continuing to attempt natural conception after the diagnostic fertility work-up? SUMMARY ANSWER: Exploration of the experiences of couples showed that couples would have appreciated fertility clinic staff embedding expectant management into the fertility clinic trajectory, supportive staff with female and male patient interactions and advice on common experiences of peers and on managing their lifestyle, distress and subfertility-related sexual challenges. WHAT IS KNOWN ALREADY: Dutch and British professional guidelines advise newly diagnosed subfertile couples with a ‘good prognosis’ to continue to attempt natural conception and do not require fertility clinic staff to interact with patients. Fertility clinic staff and subfertile couples struggle to follow these guidelines as they feel an urgent need for action. Subfertile couples might benefit from sexual advice, as subfertility is negatively associated with sexual functioning, which is important for natural conception. STUDY DESIGN, SIZE, DURATION: Twelve one-time in-depth interviews (2015–2017) were conducted with 10 heterosexual couples and 2 women whose partners did not participate, then the interviews were subjected to inductive content analysis, reaching inductive thematic saturation. PARTICIPANTS/MATERIALS, SETTING, METHODS: The 22 interviewees had experienced 3–18 months of expectant management after their diagnostic fertility work-up in a Belgian or a Dutch tertiary fertility clinic. The face-to-face in-depth interviews explored positive and negative experiences and unmet needs. The transcribed interviews were subjected to inductive content analysis, by two researchers discussing initial disagreements. MAIN RESULTS AND THE ROLE OF CHANCE: Couples would appreciate fertility clinic staff embedding expectant management in the fertility clinic trajectory, by starting off with reassuring couples that their very thorough diagnostic fertility work-up demonstrated their good chance of natural conception, and by involving couples in deciding on the duration of expectant management and by planning the follow-up appointment after expectant management up front. Couples had encountered sexual challenges during expectant management and had an interest in sexual advice, focused on increasing pleasure and partner bonding and preventing the rise of dysfunctions. The couples agreed that a (secured) website with evidence-based, non-patronizing text and mixed media would be an appropriate format for a novel support programme. Couples were keen for interactions with fertility clinic staff which addressed both partners of subfertile couples. Couples also valued advice on managing their lifestyle and distress and would have liked information on the experiences of their peers. LIMITATIONS, REASONS FOR CAUTION: Recall bias is plausible given the retrospective nature of this study. This explorative interview study was not designed for examining country or gender differences in experiences and needs but it did generate new findings on inter-country differences. WIDER IMPLICATIONS OF THE FINDINGS: Rather than simply advising expectant management, fertility clinics are encouraged to offer couples who continue to attempt natural conception after their diagnostic fertility work-up, supportive patient–staff interactions with advice on common experiences of peers and on managing their lifestyle, distress and sexual challenges related to subfertility. STUDY FUNDING/COMPETING INTEREST(S): Funded by Flanders Research Foundation and the University of Amsterdam. There are no competing interests. TRIAL REGISTRATION NUMBER: N/A. Oxford University Press 2022-09-15 /pmc/articles/PMC9479888/ /pubmed/36134038 http://dx.doi.org/10.1093/hropen/hoac037 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Dreischor, Felicia Laan, Ellen T M Peeters, Fleur Peeraer, Karen Lambalk, Cornelis B Goddijn, Mariëtte Custers, Inge M Dancet, Eline A F The needs of subfertile couples continuing to attempt natural conception: in-depth interviews |
title | The needs of subfertile couples continuing to attempt natural conception: in-depth interviews |
title_full | The needs of subfertile couples continuing to attempt natural conception: in-depth interviews |
title_fullStr | The needs of subfertile couples continuing to attempt natural conception: in-depth interviews |
title_full_unstemmed | The needs of subfertile couples continuing to attempt natural conception: in-depth interviews |
title_short | The needs of subfertile couples continuing to attempt natural conception: in-depth interviews |
title_sort | needs of subfertile couples continuing to attempt natural conception: in-depth interviews |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479888/ https://www.ncbi.nlm.nih.gov/pubmed/36134038 http://dx.doi.org/10.1093/hropen/hoac037 |
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