Clinical Practice Operations · Care Team and Roles
RRM Academy Synopsis
Italian center builds a team-based care path for infertile couples
One Italian service's care path for infertile couples scores seven measures. One of two example couples conceived naturally at the sixteenth monitored cycle. The report has two cases and no comparison group.
Key Findings
- The Fertile Family Path started in 2018 at a counseling center in Treviso, Italy, run with the local socio-health unit.
- The team includes a gynecologist, an endocrinologist, an andrologist, a fertility awareness practitioner, and a psychologist.
- The path scores seven dimensions on six-level Likert scales: three medical, three psycho-relational, plus life satisfaction.
- Couple 1 (both aged 31, two miscarriages the year before) was monitored for 15 cycles, September 2018 to October 2019. Natural conception came at the sixteenth cycle.
- Couple 2 (aged 40 and 35) was monitored for 14 cycles without natural conception. Psycho-relational ratings worsened, which the authors say clarifies why the couple ended their search and sought couple psychotherapy.
Interpretation
The authors built a monitoring system and show how it reads on two couples they chose as illustrations, one that conceived and one that did not. With two couples and no comparison group, the paper reports no success rate and cannot show that the path caused the conception. The authors write that further studies must clarify each variable's role and show efficacy on a large scale.
RRM Context
The path checks both partners and teaches couples to spot the fertile window from body signs. Both fit RRM's couple-level, cycle-charting principles. The authors offer the service as an alternative to assisted reproductive techniques. The paper has no head-to-head data.
Abstract
The Path of Fertile Family (FFP) is a service for couples experiencing infertility, aimed to obtain natural conception, as an alternative to assisted reproductive techniques, developed in 2018 and provided by the Counseling Centre of Centro della Famiglia Foundation, an institute of culture and pastoral care of the Diocese of Treviso, in cooperation with the local socio-health unit. FFP offers to infertile couples a specific multidisciplinary path of care, including the involvement of specific gynecological, andrological, endocrinological, and psycho-relational competences, together with fertility awareness. It represents an “experiential laboratory” for the multidisciplinary diagnosis and treatment of infertility, for understanding relational processes, for the development of operational strategies and above all for the verification of the goodness of a lifestyle that is able to harmonize the couple’s project and the family’s project, couple satisfaction and parental openness. The setting of the service draws inspiration and reference from three paradigms from which significant ethical choices derive: the ecological perspective of fertility, the relational intimacy of the couple and a multidisciplinary approach. From the three founding paradigms, FFP model has been developed and progressively implemented in order to define a specific FFP Quality of Care Path (QCP) for couple infertility. Although further studies are needed to better clarify the role of each studied variable in a complex monitoring system, we identified for the first time a QCP Path based on 7 variables we present here two illustrative cases: the first one in which a natural conception has been obtained and the second one, in which the focus has been moved from natural conception to the reconstruction of relational competence. Further studies will demonstrate, on large scale, the efficacy of our protocol and of the analyzed variables.
Summary
This paper provides an overview of the conceptual and methodological process of implementing the monitoring of the path of infertile couples towards natural conception in harmony with their relational life project. A multi-professional team accompanies couples in overcoming the obstacles to fertility and in the progressive awareness that parenting is not only biological. The result is a range of goals to strive for. The reference paradigms of the service justify the ethical choices of the couple and the team. The operating protocol supports the couple commitment and guides professionals in their effective action if competent and concerted. The variables identified are the monitoring tool that gradually indicates the degree of the path progress.
Topics
Cite this article
Grande, G., Colesso, W., Gava, S., Conto, U. D., & Cusinato, M. (2022). A Multidisciplinary Quality of Care Path For Couple Infertility: Development of An Integrated Approach Founded on A Multidisciplinary, Personalistic, and Ecological Model For Couple Fertility. The Linacre Quarterly. https://doi.org/10.1177/00243639221081980
Grande G, Colesso W, Gava S, Conto UD, Cusinato M. A Multidisciplinary Quality of Care Path For Couple Infertility: Development of An Integrated Approach Founded on A Multidisciplinary, Personalistic, and Ecological Model For Couple Fertility. The Linacre Quarterly. 2022. doi:10.1177/00243639221081980
Grande, G., et al. "A Multidisciplinary Quality of Care Path For Couple Infertility: Development of An Integrated Approach Founded on A Multidisciplinary, Personalistic, and Ecological Model For Couple Fertility." The Linacre Quarterly, 2022.