Reviewer ’s report  
Title: Impediments to comm unication and relationships between  infertility care providers and 
patients  
 
Version: 0 Date: 29 Apr 2017  
 
Reviewer: Phyllis Zelkowitz  
 
Reviewer's report:  
This paper explores an interesting and important topic, namely impediments to the provision of 
patient -centered care by fertility health care providers. While there has been some research on 
patient views of gaps in patient -centered care, the author states that there have been no studies of 
the perspectives of health care providers. There have been some studi es that have examined the 
stressors faced by fertility health care providers, some of which are reviewed in the 2012 paper 
by Boivin and colleagues (Human Reproduction, vol 27, pp 941 -950). Fitzgerald and colleagues 
(Human Reproduction, 2013, vol. 28, pp 1 289-1296) discuss the "emotional work" of fertility 
health care providers). Anne Kerr examines differences in attitudes of health care providers in 
public and private fertility clinics (Sociology of Health and Illness, 2013, vol 35, pp 465 -478). 
This liter ature could be considered in the introductory section of the paper. The paper's stated 
aim is to examine the perspective of health care providers. However, the sample is comprised of 
several patients, and the results section includes many quotes from patie nt interviews. The 
introduction and methods should make it clear why patient interviews are included in this 
analysis. The methods section needs to be elaborated. Why were the background interviews not 
included in the final analysis? What questions were as ked of patients? Were the interviews 
recorded in some way? Please provide information on the gender of the health care providers and 
the patients, plus any other relevant information about study participants, such as patient age and 
diagnosis. How many pat ients interviewed had successful treatment outcomes? Qualitative 
methods are entirely appropriate for a study of this type. However, qualitative reports generally 
identify a few themes. Could the author consider collapsing some of the themes into broader, 
more general categories? The discussion seems to refer back to issues identified in the 
introductory section, rather than the results of the study.  
There are occasionally words or phrases missing in the paper.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
Are the conclusio ns drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
Quality of written English  
Please indicate the quality of language in the manuscript : 
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that  may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, eith er now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, writ e 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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