Lived experience of infertility and in vitro fertilisation treatment.

BACKGROUND: Infertility is a medical and psychosocial problem that affects one in six couples worldwide. Infertility is increasing largely due to people starting families later, a decrease in the quality of sperm due to environmental and lifestyle factors and rising rates of obesity in both men and women. As a result, general practitioners (GPs) are increasingly seeing patients for fertility-related consultations. Nearly half of these GP consultations will result in a referral to a fertility clinic or relevant specialist. Approximately 5% of children now born in Australia are born as a result of assisted reproductive treatment. OBJECTIVE: In Australia, GPs are the primary access point for reproductive care. They can play a central role in educating, preparing and supporting their patients and ensuring timely and appropriate intervention and referral. This paper describes the lived experience of those dealing with infertility, particularly the emotional challenges of infertility and its treatment, to help GPs support their patients throughout treatment and beyond. DISCUSSION: Infertility and fertility treatment can have a significant impact on the psychological wellbeing of both men and women, as well as their relationships with one another, their family and friends. GPs are well placed to establish a trusting and supportive relationship during one of the most stressful periods of their patients' lives, to notice changes in wellbeing, functioning and relationship satisfaction and to facilitate timely referral to appropriate resources.

Attitudes of sperm, egg and embryo donors and recipients towards genetic information and screening of donors.

BACKGROUND: Gamete and embryo donors undergo genetic screening procedures in order to maximise the health of donor-conceived offspring. In the era of genomic medicine, expanded genetic screening may be offered to donors for the purpose of avoiding transmission of harmful genetic mutations. The objective of this study was to explore the attitudes of donors and recipients toward the expanded genetic screening of donors. METHODS: Qualitative interview study with thematic analysis, undertaken in a tertiary fertility centre. Semi-structured in-depth qualitative interviews were conducted with eleven recipients and nine donors from three different cohorts (sperm, egg and embryo donors/recipients). RESULTS: Donors and recipients acknowledged the importance of genetic information and were comfortable with the existing level of genetic screening of donors. Recipients recognised some potential benefits of expanded genetic screening of donors; however both recipients and donors were apprehensive about extended genomic technologies, with concerns about how this information would be used and the ethics of genetic selectivity. CONCLUSION: Participants in donor programs support some level of genetic screening of donors, but are wary of expanding genetic screening beyond current levels.