L26/P-571 More than a medical journey: identifying emotional experiences of ART patients to provide targeted psychological support

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Abstract Study question What issues should be explored in order to provide targeted psychological support to patients undergoing assisted reproductive technology (ART)? Summary answer ART treatment is emotionally intense and challenging for patients, who should receive adequate and specific psychological support throughout the entire treatment. What is known already Couples need to make considerable mental and physical efforts to accept infertility and undergo ART treatment. In Italy, the number of couples undergoing ART cycles has steadily increased, from 71,741 in 2013 to 89,870 in 2023, with a 23.2% increase in the number of treatment cycles. ART has unique characteristics, including couple involvement, short time intervals between the treatment phases, high uncertainty of success and the need for repeated attempts. These features highlight the importance of a good patient-medical staff relationship and the need for targeted and functional psychological support addressing this complexity. Study design, size, duration Between 2021 and 2023, the Italian Register of Assisted Reproduction (IARTR), in collaboration with the Department of Dynamic and Clinical Psychology and Health Sciences of La Sapienza University, administered two ad hoc online questionnaires to patients undergoing ART treatment. The text of the open-ended question was analysed using thematic analysis. Participants/materials, setting, methods A total of 481 patients undergoing ART completed the questionnaire. The open-ended question ‘Can you tell us about your experience with ART?’ was analysed to outline the key themes relevant to the development of psychological support for ART. Qualitative analysis was performed using the thematic analysis method, which involves several step-process: familiarization with the data; generation of initial codes; search, review, and naming of themes; presentation of results through a coherent narrative. Main results and the role of chance The thematic analysis identified seven key themes grouping the coded data: 1) “the couple” to be safeguarded and supported; considered as a resource and as a starting point for new life projects; 2) “treatment as a source of difficulty” dealing with infertility, failure, therapeutic choices and economic, social, emotional challenges; 3) “treatment with gamete donation as a possibility” representing a solution, hope and an opportunity to become parents; 4) “need for time to process” infertility, failures and biological bereavement; 5) “relationship with medical staff as a source of” reassurance, information, professional support and non-judgmental listening; 6) “importance of discussion with” other couples, psychologist and the centre staff; 7) “emotional complexity including” fear, anxiety, sadness, frustration, anger, fatigue, inadequacy, envy, shame, hope, trust, determination, responsibility, love and serenity. Patients undergoing ART experience many conflicting emotions related to the challenges of treatment. These emotions require time to process and integrate experiences of infertility, failure, and bereavement. Sharing these experiences with other couples, psychologists, and medical staff emerges as a key supportive factor. A positive relationship with medical staff can provides guidance in decision-making and reassurance. Treatment with gamete donation is perceived as an opportunity and a source of hope for achieving parenthood. Limitations, reasons for caution The issues identified through qualitative analysis methodology should be further explored using the development of quantitative tools to be proposed to patients, allowing greater standardisation and generalization of the findings. Wider implications of the findings ART treatment is a clinically, emotionally, socially and economically complex experience. Patients should be offered targeted psychological support that takes this complexity into account. Identifying specific issues/experiences of patients can contribute to the development of targeted psychological interventions tailored to the specific characteristics of ART treatment. Trial registration number No

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