Page 72 - Shared Guideline Development Experiences in Fertility Care
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Chapter 4
tool for patients in the development of a multidisciplinary CPG on infertility and aimed to assess its feasibility.
Methods
Setting
Fertility Care
In the Netherlands, fertility care is mostly publically arranged and provided by various professionals. First, fertility care is provided by the general practitioner and may be part of an initial fertility assessment a er a prolonged time of unwanted nonconception. Second, the general practitioner can refer couples to a gynaecologist in a general (secondary care) or a university (tertiary care) hospital to complete the fertility assessment, determine a cause of infertility, and de ne a suitable treatment policy. ird, if a severe male factor is diagnosed, a urologist may be consulted. Furthermore, since infertility has a high emotional and psychological impact, which also interferes with work, a psychologist and occupational physician are regularly engaged in the care pathway. In vitro fertilization and intracytoplasmic sperm injection are provided by 13 licensed hospitals (8 university hospitals, 4 general hospitals, and 1 private clinic). Ovulation induction and intrauterine insemination are performed in all Dutch hospitals. Ovulation induction, intrauterine insemination cycles, and the rst three in vitro fertilization or intracytoplasmic sperm injection treatment cycles are reimbursed as part of the basic health care package according to the Health Insurance Act.
Guideline Development
In February 2008, a collaboration of stakeholders (a general practitioner, 2 gynaecologists, a urologist/sexologist, a clinical embryologist, a clinical chemical specialist, a medical psychologist, an occupational physician, 2 patients’ representatives, and a researcher) was set up to develop a national multidisciplinary paper-based CPG on infertility. CPGs are de ned as sets of evidence- or consensus- based recommendations describing optimal patient care to assist health care professionals and patients in clinical decision-making [2]. e aim of the CPG was to focus on organizational and patient-centred aspects of fertility care. Two representatives of the Dutch patients’ association for infertility, Freya, participated
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