P-498 Psychological care during ART treatments In Italy: the patients’ point of view
Authors: Fedele F , Spoletini R , Di Trani M , Renzi A , Scaravelli G 
Published: June 2022

Abstract

Study question
What are the characteristics of the psychological care and the emotional needs of couples undergoing ART treatment in Italy?

Summary answer
The presence of psychological support services in ART centers is poorly communicated to patients, with less than half being advised to take a pathway.

What is known already
Couples who decide to undergo ART treatment show significantly higher depression and shame scores, lower acceptance and self-compassion scores, greater reliance and avoidant coping strategies. Couples experience the procedure as source of stress, anxiety and pain, fluctuating between hope and despair, and all of this seem to negatively impact on treatment continuation and outcomes. A review of 25 studies using different psychological interventions (counseling, focused educational interventions and integrated educational programs) found positive effects on anxiety (61.5%), depression (38.4%) and infertility-related stress (100%) reduction. Several studies showed the effectiveness of psychological intervention in promoting pregnancy rates.

Study design, size, duration
The ART Italian National Register (National Health Institute) with the Department of Dynamic and Clinical Psychology and Health Studies (Sapienza University) proposed a national survey to 195 Italian ART centres and patient associations. Patient associations and the Medical Director of each centre were invited by e-mail to participate and to encourage all patients to fill a questionnaire made available on an on-line platform. Data collection was between March to October 2021.

Participants/materials, setting, methods
324 ART patients completed an online questionnaire consisting of 19 closed-ended and 8 open-ended questions. In this abstract we focus on the closed-ended questions. The questionnaire was created ad hoc for the survey starting from a previous study on the characteristics of the services offered in Italian ART centres.

Main results and the role of chance
In 90% of cases women responded to the questionnaire, only 10% of responses were from men. On average, participants are 38 years old, married (60%), and have a bachelor's degree or post-graduate degree (59%). In half of the cases respondents are employed. In 68% of cases, participants performed ART treatment in centers with public service.
Most of the respondents are facing their first or second ART cycle. They share their infertility condition with family and friends, and in 60% of cases they have been informed of the presence of the psychological service, mainly from gynecologists and through informed consent. Only in 31% of cases patients were invited to undertake psychological counseling, strongly recommended to only 8% of them. In fact, 65% of respondents never had a meeting with the psychologist during ART treatment. Those who resorted to counseling had mainly couple (45%) and individual (31.3%) meetings. Participants did not know the cost of counseling, would prefer it to be included in the cost of ART treatment, and would like it to be available throughout treatment The main emotions felt during ART treatment are sadness, fear and anger, those attributed to the partner are the same but joy also appears.

Limitations, reasons for caution
Firstly the limited sample size, mainly related to the ability of ART center staff to spread the initiative among patients.
The low response from male partners, that could be related to their rare presence in ART centers, as the medical treatment is mainly targeted to women.

Wider implications of the findings
In conclusion, the results show that psychological services in Italian ART centers are not yet fully operational and integrated in the ART procedure. All this highlights the importance of further investigations with the aim of sharing information to establish common protocols for psychological interventions in ART centres.

Trial registration number
Not applicable