ASRM 2013 Update: Patient Communication Poster from Reader’s Feedback

October 18, 2013Carole 3 Comments »

Some of you may have participated in my call-out post for patient feedback on your communication experience with your doctors, nurses and lab staff. I incorporated many of your comments and data from my blog usage statistics (Google Analytics) in my analysis of which topics seem to be of most interest to patients in order to show IVF teams some areas in which they can improve their communication methods or approach with patients. This analysis was presented in poster form at the last ASRM poster session yesterday morning. THANK YOU to all the readers who submitted comments which were used anonymously. Some were edited for length but I worked hard to preserve the essential message from each of you.

Here’s a link to the actual poster if you want to read the details. ASRM-2013-UPLOADED-POSTER

Here’s a picture of me with the poster IMG_0760. It was great to see old friends and colleagues and learn about new advances in the field. Fertility Lab Insider is still unique in that it provides information about lab topics without any commercial interest. I am not affiliated or promoting any particular clinic or practice. I think this may explain some of why it has been a popular resource, receiving around 140,000 visitors from more than 10 countries in the last three years

Some Take Home Messages from the analysis of the blog data over the past three years include:

Readers of the blog are very interested in lab information- in the context of what it means for their chances of pregnancy. For instance, the most popular post ever was Embryo stages, progression and pregnancy outcome.   This post had plenty of embryo photos at different stages of development during the first five days after fertilization- the pre-implantation period. I explain what the evolving features of the embryo are –and more importantly- what they mean. The comment section of this post has been a popular place to pose questions to me or other blog readers and evolved into a spontaneous “chat” forum.

Readers were also interested in understanding what lab tests for sperm and scoring systems for embryos meant- again in terms of what it meant for them clinically- either in guiding treatment options or in understanding how likely they were to get pregnant.  Top posts for these questions were: Sperm Morphology: Kruger’s Strict vs. WHO criteria, what’s the difference? and  Understanding the Gardner blastocyst scale grading scale. Another area of confusion for patients that can be better explained by IVF personnel is that it is normal to have a loss of usable eggs and embryos at each stage of development. Not all follicles contain mature eggs. Not all eggs will fertilize. Not every embryo will progress all the way to an implantable stage of development. This issue of attrition is explained in the article Egg Count Mathematics: Why the numbers change between retrieval and transfer. 

Other topics of interest where related to IUIs and how well they work , when to stop IVF, financial issues, fertilization failure, no sperm on retrieval day, medications that affect sperm quality and Day 3 vs. Day 5 culture. 

Perhaps not surprisingly, based on comments from patients, patients really appreciated timely information about the progression of their IVF case.Frequent updates were appreciated, as well as having a way to get a deeper explanation of the embryology report when desired.

Transparency matters. One patient recounted her experience with  receiving a “white lie” explanation for the loss of an embryo, namely “embryo did not survive”, instead of the more completely transparent, “embryo did not survive because straw broke”. The first implies that the embryo could have an inherent defect and patient may never become pregnant. The second more truthful answer admits to a technical issue that is far more common than most patients realize although they have surely signed an informed consent document that spells out the technical risks of embryo handling, freezing and thawing. Incidents like these happen, either because of a flaw in the straw itself or technical error during freezing/thawing. Programs need to acknowledge and inform patients about these risks up front AND be truthful when these technical incidents do occur.

Along the same lines, patients really wanted more emotional sensitivity about their infertility. Some patients are really distressed by seeing all the happy smiling baby pictures of clinic staff. Many programs have acknowledged this and asked staff to not display pictures of their own successful fertility. At the meeting, I spoke with one person whose clinic actually took down ALL the baby pics- even from successful patients – that are displayed on the walls in many clinics.

Another common piece of patient communication feedback was that patients really often hunger for more information to understand their situation, their options and their chances of success with a particular treatment plan.  Understandably, patients who read THIS lab-oriented blog may be more interested in lab topics than the average patient but it is probably good to err on more, not less information when speaking with patients. Of course, that information is only useful if it is put in context and clearly stated with minimal medical jargon.

IMG_0749When my professors taught about the spermatogenesis cycle, I don’t think this is what they meant. Many thanks to the good sport at the Seattle Sperm Bank booth for taking this pic of me riding the sperm cycle.

In the following days and weeks, I’ll post some more ASRM updates to share with you what fertility lab insiders at the ASRM meeting are talking about.

 

© 2013, Carole. All rights reserved.

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