Counselling--its role in the infertility team

Counselling was made a statutory requirement for clinics providing assisted reproduction services as a result of the concern raised that these treatments would raise uniquely challenging emotional and ethical problems for patients. Before the Human Fertilisation and Embryology Act 1990, few counsellors specialized in this field and there were no standards for their training or experience. In the intervening years considerable progress has been made in these areas. The research evidence, which informs their practice concerning the impact of infertility and its treatment, has also grown very substantially. There is now a reasonable consensus about the broad nature of the emotional and psychological sequelae, although many unexplored questions remain. In addition, the literature providing evidence for the efficacy and effectiveness of counselling in other areas has developed in both quantity and sophistication. Counsellors are often well-placed to work with patient groups and also with the multidisciplinary assisted conception team itself on the very difficult psychosocial and ethical issues faced in practice. The sophisticated research in these fields has not yet been done in the context of infertility; it is therefore necessary to extrapolate from other fields, especially in mental health practice. This article will argue that there is now ample evidence to support the decisions made by legislators in requiring counselling to be available to patients in assisted conception units. The infertility counselling profession is in a position to begin contributing to the generation of research relevant to this field.