The persistence of grief beyond an IVF cycle outcome

Background

Researchers have identified that the emotional burden of fertility treatment contributes significantly to treatment drop out (Kim et al., 2012) and that negative emotional responses are strongly related to the outcome of the treatment, rather than coping with treatment itself (Verhaak et al., 2007). Additionally, perceived levels of social support can be a significant indicator of increased psychological distress during treatment suggesting that this can be an important protective factor in moderating psychological adjustment to infertility (Wong et al., 2015).

Aim

To investigate the primary focus of supportive counselling sessions, the patient’s perceived primary sources of support, and when patients voluntarily engage in supportive counselling to develop targeted interventions and better understand the impetus for requesting these sessions.

Method

A quality assurance study explored the frequency and content of supportive counselling sessions between March and September 2024 at a Victorian assisted reproductive technology (ART) clinic.

Results

A sample of 129 supportive counselling sessions, provided to 83 individuals, was analysed with some participants accessing several sessions during this time. Results showed that the majority (n = 67) of sessions occurred outside of an IVF cycle for the primary reason of assistance with grief and loss, even when pregnancies had been achieved. This grief and loss encompassed loss of hope, feelings of loss and isolation within their relationship, loss of conceiving spontaneously, and for past and possible current pregnancy losses. Primary sources of support were identified as partners for heterosexual and same sex couples. Single women, however, identified family as their primary support, except for single women with mental health issues who identified friends as their primary support.

Conclusion

Grief is multifaceted and persists beyond the outcome of a cycle. It is possible that patients perceive that their primary sources of support are less available or attentive after a cycle has ended, increasing vulnerability in between IVF cycles and therefore an increase in utilisation of the clinic counselling service. Counselling around treatment expectations and targeting counselling interventions to patients outside of a treatment cycle may help patients remain engaged and build resilience for future treatment. Per Verhaak (2007) recommendations, counselling services should be specifically targeted to help patients adjust to the possibility of unwelcome treatment outcomes such as childlessness rather than help patients cope with the impact of treatment itself.