Testicular biopsy before ART: the patients’ perspective on the quality of care

• Published in: Human reproduction (Oxford) 2010-12, Vol.25 (12), p.3072-3082
• Main Authors: Dancet, E.A.F., Spiessens, C., Blocquiaux, L., Sermeus, W., Vanderschueren, D., D'Hooghe, T.M.
• Format: Article
• Language: English
• Subjects: assisted reproductive technology; Attitude of Health Personnel; Biological and medical sciences; Biopsy; Gynecology. Andrology. Obstetrics; Humans; Interviews as Topic; Male; Medical sciences; men; Patient Satisfaction; Patient-Centered Care; patients; Quality of Health Care; Reproductive Techniques, Assisted; Sperm Retrieval - psychology; Spermatozoa; Surveys and Questionnaires; TESE; Testis - cytology; Treatment Outcome
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/deq262

BACKGROUND So far, research on the patients’ perspective on fertility care has mainly focused on women. Our primary aim was to explore what is important to men with respect to care related to testicular sperm extraction (TESE) and to identify strengths and weaknesses of that care. METHODS This was a mixed-method study including phenomenology on interviews with 17 ‘interview participants’ (a purposive sample with diversification for the TESE result) who received a TESE treatment at a tertiary university clinic. Strengths and weaknesses of our TESE-related quality of care were identified. Additionally, a telephone questionnaire was answered by 15 ‘rating participants’ not willing to be interviewed and the questionnaire was analyzed quantitatively. RESULTS Interview participants wanted more than effective treatment and attached importance to the attitude of fertility clinic staff, information, time flow, personalized care, ‘all that is necessary’, coaching, a homely atmosphere, continuity, privacy and separate accommodation. The satisfaction of rating participants (independent of the TESE result) was problematic for ‘overall experience’, ‘physician at the day clinic’ and ‘gynecologist at discussion of the result’. The attitude of fertility clinic staff and information were the most obvious strengths of our TESE-related care. Weaknesses were lack of practical information on post-surgical recovery and waiting times in the waiting room. CONCLUSIONS TESE patients focus not only on clinical effectiveness but also on patient-centeredness of care, and this has led to organizational changes and a new patient information brochure in our center. Qualitative research is useful to examine, understand and improve the patient-centeredness of care.