Model of counselling of infertile couples

Infertility consultations consist in highly specialized biomedical diagnostic and therapeutic interventions and at the same time in complex, emotional and cognitive interactions between the couple and the infertility team. The interpersonal, communicative part of the encounter has not been investigated so far systematically. We have based on qualitative methods developed a model of the interpersonal problem solution process which comprises ten phases, characterized by specific elements: Introduction and initiation of a therapeutic relationship, problem assessment and problem monitoring, negotiation about problem definition and about objectives and priorities of cooperation, hypothesis generation and decision making concerning diagnostic workup, investigations and diagnostic procedures, information giving about results, elaboration of treatment options, decision making about specific treatment, treatment procedures, evaluation of results. Each phase is characterized by functions, objectives, contents and communication skills, typical problems of communication and problem solution strategies. The knowledge of these phases and the understanding of the emotional, cognitive and interpersonal process couples are going through as well as the learning of respective communicative skills by the team present important elements of the quality of care which may be as important as the quality of the biomedical cure.