Working With Infertile Couples Seeking Assisted Reproduction: An Interpretative Phenomenological Study With Infertility Care Providers

Integrated Behavioral Health Care in Reproductive Medicine: How and Why to Include Mental Health Professionals in Infertility Care Teams

Despite fertility patients' reports of significant distress, few have access to integrated mental health care services. We elucidate the benefits and challenges of mental health integration in infertility practices from the perspective of both patients and providers. We outline specific models of integration, financial viability, and the first steps fertility clinics could take to improve their patients' access to these critical supports.

Modification of Case-Based Reasoning Similarity Formula to Enhance the Performance of Smart System in Handling the Complaints of in vitro Fertilization Program Patients

Objectives

Eighty percent of in vitro fertilization (IVF) patients have high anxiety levels, which influence the success of IVF and drive IVF patients to quickly report any abnormal symptoms. Rapid responses from fertility subspecialist doctors may reduce patients’ anxiety levels, but fertility subspecialist doctors’ high workload and their patients’ worsening health conditions make them unable to handle IVF patients’ complaints quickly. Research suggests that smart systems using case-based reasoning (CBR) can help doctors handle patients quickly. However, a prior study reported enhanced accuracy by modifying the CBR similarity formula based on Lin’s similarity theory to generate the Chris case-based reasoning (CCBR) similarity formula.

Methods

The data were validated through interviews with two fertility subspecialist doctors, interviews with two IVF patients, a questionnaire administered to 17 community members, the relevant literature, and 256 records with data on IVF patients’ complaints and how they were handled. An experiment compared the performance of the CBR similarity formula algorithm with the CCBR similarity formula algorithm.

Results

A confusion matrix showed that the CCBR similarity formula had an accuracy value of 52.58% and a precision value of 100%. Fertility subspecialist doctors stated that 89.69% of the CCBR similarity formula recommendations were accurate.

Conclusions

We recommend applying a combination of the CCBR similarity formula and a minimum reference value of 80% with a CBR smart system for handling IVF patients’ complaints. This recommendation for an accurate system produced by the CBR similarity formula may help fertility subspecialist doctors handle IVF patients’ complaints.

Perceptions of Fertility Physicians Treating Women Undergoing IVF Using an Egg Donation

In the course of their work, medical teams are routinely exposed to difficult and stressful situations. The few studies in the literature that have examined physicians’ perceptions and responses to such situations have focused primarily on the fields of emergency medicine and chronic and terminal illness. However, the field of fertility medicine can also evoke complex feelings among physicians. The present qualitative study examined the perceptions of fertility physicians treating women undergoing egg donation. Semi-structured in-depth interviews were conducted with 20 fertility physicians, and a categorical analysis was performed. The main category to emerge was the physicians’ perception of egg donation and its implications. Two prominent themes were identified within this category: doctor–patient communication surrounding egg donation and how the idea was presented to the patient; and doctors’ perception of the implications of egg donation, including maternal identity, the relationship between mother and infant, and the mother’s sense of the child’s identity. This is the first study to consider the response to fertility treatments, a contemporary and sensitive topic, from the perspective of the physicians. The findings can contribute to physicians’ understanding of themselves and can help to devise ways to assist them in managing their emotional responses to their work for the benefit of both themselves and their patients.