From Evidence to Impact: Translating Research on Quality of Life, Wellbeing, and Spirituality into Person-Centred Fertility Care - European Medical Journal

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From Evidence to Impact: Translating Research on Quality of Life, Wellbeing, and Spirituality into Person-Centred Fertility Care

2 Mins
Reproductive Health
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Authors:
* Madeleine Bernet , 1,2 Alexander M. Quaas , 3 Michael von Wolff , 4 Eva Soom Ammann , 1 Arndt Büssing 2
  • 1. Division of Nursing, Department of Health Professions, Bern University of Applied Sciences, Switzerland
  • 2. Faculty of Health, Witten/Herdecke University, Germany
  • 3. Shady Grove Fertility, San Diego, California, USA
  • 4. University Women's Hospital, Division of Gynaecological Endocrinology and Reproductive Medicine, Inselspital, University Hospital, Berne, Switzerland
*Correspondence to [email protected]
Disclosure:

Bernet has received funding and/or grants for the present work from the Zonta Club Bern and the Bern University of Applied Sciences, with payments made to the individual. Quaas has served as an advisor for Ferring Pharmaceuticals. The other authors have declared no conflicts of interest.

Acknowledgements:

The authors gratefully acknowledge the contributions of the HoPE study’s participants and professionals. There are no conflicts of interest. The study received ethical approval from the Cantonal Ethics Committee of Bern (BASEC-No: Req-2021–00532) and the Ethics Committee of the University of Witten/Herdecke (Nr. S-114/2022).

Keywords:
Infertility, nursing science, patient-centred care, quality of life, reproductive medicine, spiritual needs.
Citation:
EMJ Repro Health. ;12[1]:51-52. https://doi.org/10.33590/emjreprohealth/6243VT04.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

BACKGROUND AND AIMS

Infertility affects approximately one in six individuals worldwide and extends far beyond its biological dimensions, affecting emotional wellbeing, quality of life, and psychosocial health.1,2 While reproductive medicine has achieved remarkable technological advances, fertility care continues to focus primarily on medical treatment and pregnancy outcomes. Emotional, psychosocial, and spiritual dimensions of infertility remain insufficiently addressed despite their profound impact on affected individuals.2-5

The HoPE study (Health care users’ and Professionals’ Perspectives and Experiences in Fertility Treatment in Switzerland) was designed to generate evidence for more holistic, patient-centred fertility care in Switzerland.6,7

MATERIALS AND METHODS

Using an explanatory sequential mixed-methods design, the study combined a nationwide multilingual online survey (German, French, and Italian) of individuals with an unfulfilled desire for children (n=326) with semi-structured interviews (n=26) and three focus group discussions with healthcare professionals in reproductive medicine (n=20). Validated instruments assessed fertility-related quality of life (Fertility Quality of Life [FertiQoL]),8 psychological wellbeing (World Health Organization-Five Well-Being Index [WHO-5]),9 and spiritual needs (Spiritual Needs Questionnaire-20 [SpNQ-20]),10 while qualitative data explored lived experiences and opportunities to improve fertility care.

RESULTS

The findings confirmed the multidimensional impact of infertility, revealing substantial emotional, psychosocial, and existential burden. Emotional quality of life was the lowest of all FertiQoL domains (mean score [M]=46.35), and participants reported reduced psychological wellbeing (WHO-5: M=13.89) together with substantial needs for inner peace, meaning, and support. Spiritual needs were particularly pronounced among individuals without children (SpNQ-20 inner peace: M=1.82), who also experienced significantly greater emotional and existential burden than participants who already had children. Qualitative findings revealed infertility as a prolonged experience of uncertainty, repeated disappointment, decision-making pressure, social isolation, and insufficient societal recognition. Participants frequently perceived a lack of understanding not only within their social environment but also within healthcare services.

Healthcare professionals confirmed the considerable psychosocial burden experienced by people undergoing fertility treatment, while identifying structural barriers, including limited consultation time, fragmented care pathways, and insufficient integration of psychosocial support into routine fertility services. They advocated for stronger interprofessional collaboration and coordinated care models that address the emotional, psychosocial, and existential dimensions of infertility alongside medical treatment.6,7

A key strength of the HoPE project is its successful translation of research into education, clinical practice, and health policy. The findings informed the development of innovative continuing education programmes (Certificate of Advanced Studies and Short Advanced Studies) at Bern University of Applied Sciences, Switzerland, designed to strengthen competencies in person-centred, interprofessional, and psychosocially informed reproductive healthcare among physicians, nurses, midwives, counsellors, medical practice assistants, and other healthcare professionals.

Based on the results, an evidence-based patient information brochure was co-developed to support individuals during the emotionally challenging waiting period between embryo transfer and pregnancy testing, translating research findings into practical guidance. The project has also contributed to national policy discussions by informing the Swiss Parliamentary Group for Family Policy on issues related to infertility, fertility care, reimbursement, and service organisation. The findings have fostered collaborations and contributed to the growing integration of psychosocial care into reproductive medicine.

CONCLUSION

The HoPE study demonstrates that infertility should be understood not only as a medical condition, but also as an emotional, psychosocial, and existential experience. Its impact illustrates how interprofessional research can drive evidence-based improvements in reproductive healthcare through interdisciplinary collaboration, person-centred care, and effective knowledge translation across education, clinical practice, patient resources, and health policy.

References
Bernet M et al. Beyond medical treatment: addressing the emotional and spiritual dimensions of infertility – a mixed-methods approach. Abstract L26/O-111. ESHRE Annual Meeting, 5-8 July, 2026. WHO. Infertility prevalence estimates, 1990–2021. 2023. Available at: https://www.who.int/publications/i/item/978920068315. Last accessed: 10 July 2026. European Society of Human Reproduction and Embryology (ESHRE). Routine psychosocial care in infertility and medically assisted reproduction: a guide for fertility staff. 2023. Available at: https://www.eshre.eu/-/media/sitecore-files/Guidelines/Psychology/ESHRE-psychology-guideline_2015_final_version-1_2.pdf. Last accessed: 10 July 2026. Lienhard M et al. Bedürfnisse von betroffenen personen während einer kinderwunschbehandlung und deren erwartungen an die pflegerische betreuung. Medical Update Marketing & Media. 2024;DOI:10.24451/dspace/11368. Sutter L et al. Psychische gesundheit im übergang zum elternsein: herausforderungen und chancen nach kinderwunschbehandlungen. Sozialpsychiatrische Informationen. 2025;55(3):46-50. Bernet M et al. Quality of life, spiritual needs, and well-being of people affected by infertility and its treatment: quantitative results of a mixed-methods study. J Assist Reprod Genet. 2025;42:1853-62. Bernet M et al. "It's like having a second job": qualitative insights into the emotional burden of infertility and the need for coordinated care. J Psychosom Obstet Gynaecol. 2025;46(1):2505589. Boivin J et al. The Fertility Quality of Life (FertiQoL) tool: development and general psychometric properties. Fertil Steril. 2011;96(2):409-15.e3. WHO Regional Office for Europe. Wellbeing measures in primary health care: the DEPCARE project. 1998. Available at: https://iris.who.int/items/07a5e1ac-9832-4088-a25d-0338088bdb05. Last accessed: 10 July 2026. Büssing A. The Spiritual Needs Questionnaire in research and clinical application: a summary of findings. J Relig Health. 2021;60(5):3732-48.

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