Page 36 - Shared Guideline Development Experiences in Fertility Care

Chapter 2
Lack of medical knowledge. GPs and psychologists especially mentioned their inexperience in treating infertile couples.
ose psychologists do not have any expertise on childlessness.
Domain III: patients
-
Domain IV: organisation
Unclear distribution of tasks. e unclearness of the distribution of tasks between di erent professionals within fertility care is an organizational aw. Presently, it is unclear ‘who should do what’.
...sometimes patients tell me about poor information provision. at makes me wonder: who is able to pay attention to this, and where in the whole care pathway is this person who is responsible for this?
Poor quality of semen analyses. Presently, each laboratory has its own routine in performing a semen analysis (i.e. di erent tests, normal limits and measuring instruments), which can lead to di erent test results.
e laboratory, performing the semen analysis, should at least have a certi cation.
Table 4: Key clinical issues according to professionals
Domain I Characteristics of the guidelines
Lack of evidence*
Unclear treatment criteria*
Unclear treatment policy*
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*
Domain III Characteristics of the patient
Uncertain patient Age-related problems Desire for action
Taboo on infertility Lack of motivation Partner has di erent 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 Policy depends on
Ethical consequences of age- criterion
* Main key clinical issues, suggested by at least two di erent professionals in both focus groups. ** Collective main key clinical issues, suggested by both infertile couples and professionals.
34