It is important to be aware that the experience of the investigations and treatment for subfertility is likely to produce stress in the relationship due to:
invasion of the couple’s ‘intimate privacy’
the demands of the process with repeated and often painful procedures
possible family and cultural pressures from those who are not aware that there may be a problem conceiving
a feeling of isolation from their ‘fertile’ friends and resentment when others seem to be achieving pregnancies easily
possible sexual difficulties as intercourse becomes ‘goal oriented’
the difficult decision-making process when it comes to whether to continue or to stop treatments
The primary care clinician can assist a couple in this area by:
helping them sort out the facts from the myths around fertility
providing supportive counselling to clarify fears and expectations
referring to an expert fertility counsellor
addressing issues of ‘blame’ if a problem is identified in one person; subfertility is a ‘couple issue’
explaining the usual course of investigations and the time delays
outlining possible options for treatment
giving accurate information on prognosis, particularly in women of advanced age
...
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