A recent study published by The Obstetrician & Gynaecologist (TOG) highlights the psychological and personal anguish of being unable to bear children and the importance of counselling within the field of infertility. According to the study, the counsellor’s role is that of patient advocate, gatekeeper, researcher, educator, supportive resource to colleagues, confidante and point of liaison. The medical and psychological aspects of infertility treatment must be seen as a whole.
Practitioners work with patients at four levels:
Set realistic expectations Infertility can be an emotional roller coaster. Often infertile couples need to go through more than one cycle of treatment before they conceive. Each case is unique and a good counsellor sets realistic expectations and does not give them false hopes. They must be made to understand how it will affect not just them but those around them as well. While it is important to stay positive during the treatment and believe that it will all work out for the best, the couple needs to also brace themselves for the likelihood of failure.
– Inform patients about success and failures upfront-It is best that the chances of success or failure of the treatment are discussed straight up with the patient so that they are not mislead with false hope. The truth remains that with regard to ART, the success rate is only 30 to 40 percent today.
– Explain different treatment modalities available – It is the role of the counsellor to explain all treatment options and ensure they are thoroughly informed before making any treatment choices. All implications of suggested treatment must be provided to the patient before they consent to the same. For this, counselors in well-established IVF centres are well informed on current treatment options as well as keep pace with the latest advances in the field of infertility.
– Connect them to patient support groups-Counselors work with patients and help in making sense of the range of emotions and sensitive issues that they are coping with. An important way that they can help is by recommending patient support groups that will reassure the patient and help her/him cope. These groups can help work through emotions that patients can experience before, during and after treatment.
Sometimes counseling is combined with local medical techniques such as acupuncture, yoga, meditation and music therapy. High levels of stress significantly hamper the body’s fertility and managing stress during fertility treatments will help patients.
Clearly, neglecting the emotional impact of infertility and viewing it solely as a medical condition can be detrimental and affect the patient extensively. It is for this reason that in developed countries like the US and the UK, counselling is mandatory during Assisted Reproductive Therapy (ART) and is prescribed in the ART guidelines. While counselling is not an absolute must in India for ART, the service is provided by well-established fertility centres.
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