Seventy-three per cent of all couples were offered, or obliged, to receive counselling compared to 91% of those patients treated in the UK. Of the patients who took part in the survey, only 30% received counselling; over half of those patients found it either 'very helpful' or 'helpful'. No differences were observed in the perceived usefulness of counselling, comparing those patients who were offered, and chose to receive, counselling versus those who received mandatory counselling. In patients who did not receive counselling, the main reasons cited were: 'felt I can cope on my own' (37%), 'counselling was not offered' (21%), and 'did not think it would be beneficial' (15%).
Infertility is a health-care problem which has very definite physiological, psychological and social implications. Infertile couples are continually reminded of their plight--the structure of society is based on the family unit; simple activities such as shopping are a constant reminder, the shops being geared to the family; the neighbours fill their cars with all the paraphernalia which accompanies children--the stigma of infertility often leads to mental disharmony, marital difficulties, divorce, and in some cultures to ostracism. The suffering experienced by infertile people is very real. We need to remind ourselves that we are treating 'people who are infertile' rather than 'infertility'. Our care goes beyond their physical treatment--their stresses and strains are our concern and we must be careful not to add additional stress to their existing problems. Successful treatment can transform their lives: 'They are bright, healthy, beautiful children--a dream come true. Our lives are transformed and complete. Thank you a million times.' Failure after years of trying is all the more painful. The availability of effective, informed, independent and involved counselling is essential.
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