Page 34 - Shared Guideline Development Experiences in Fertility Care

Chapter 2
Poor physical environment. e lack of separate waiting rooms for pregnant and infertile couples was mentioned the most. Furthermore, lack of privacy and a ‘cold appearance’ of the hospital were mentioned.
... at is a disadvantage of our hospital: pregnant couples and people like us are sitting next to each other in the waiting room, I found that very hard.
Time pressure. Most patients mentioned time limits during appointments as a key clinical issue.
For the ultrasound only ve minutes are available, but I think they should take more time for it. It is like: ve minutes, next patient please.
Table 3: Key clinical issues according to infertile couples
Domain I Characteristics of the guidelines
Lack of evidence
Di ering protocols
Domain II Characteristics of the professional
Poor communication
Lack of respect and autonomy**
Information provision * not meeting expectations
Lack of emotional support**
Lack of medical knowledge
Lack of continuity of doctor
Unequal policy
Problems with examinations
Domain III Characteristics of the patient
Uncertain patient
Age-related problems
Desire for action
Taboo on infertility*
(Un)informed
Liberty of choice
Patients with unrealistic expectations
Need for contact with other patients
Lack of contact with GP
Domain IV Characteristics of the organization
Unclear distribution of tasks
Poor alignment of care*
Lack of attention to work*
Poor quality of semen analysis
Poor insurance coverage
Lack of arrangements concerning work
Lack of continuity of care
Lack of support a er treatment*
Non- uent care path
Standard treatment according to protocol*
Di culty making appointments
Poor availability by phone Poor physical environment* Time pressure*
* Main key clinical issues, suggested by more than three quarters of the infertile couples. ** Collective main key clinical issues, suggested by both patients and professionals.
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