More than a number – time to implement agreed psychological outcomes for infertility clinics

Many infertility clinics proudly publish their conception rates and some also publish live birth rates, an outcome of greater relevance to consumers. However, perhaps it is time for infertility services to also publish agreed psychological outcomes as well. Infertility stigma is an increasingly recognized phenomenon and affects quality of life [1]. A study by Jing et al. published in this edition demonstrates that feelings of stigma related to infertility are associated with poorer quality of life [1]. Yet, these feelings can be easily detected and alleviated through education and counseling. The process of infertility treatment itself can also impact adversely on couples and result in sexual relations and intimacy becoming a sacrificed tool for fertility and not a key aspect of dyadic relationship bonding [2]. The stress of infertility as couples navigate diagnosis and interventions to achieve their reproductive goal can adversely impact upon sexual satisfaction [2]. Counseling and education provided by infertility centers should therefore also address more than understanding of the processes involved in therapy, but extend into psychological and sexual education to address holistic quality of life. Further, within the cohorts of couples seeking infertility care are those with particular reproductive trauma. Recurrent pregnancy loss, raised and dashed hopes, can make some couples especially vulnerable to the rigors of infertility treatment [3]. These couples can also be identified with directed screening and interventions can improve their long term outcomes. It is time to think beyond numbers as a measure of success in the field of infertility care. Clinics should also be ranked on their capacity to educate and counsel and to identify those who would benefit from additional supports. Agreed patient-endorsed psychological and quality of life outcomes support should be developed and added to the mandatory reporting of infertility services to ensure individuals and couples achieve their reproductive goals and do so whilst retaining their dyadic intimacy and quality of life.