Fertility treatment after sexual trauma

What are the experiences, needs and preferences of women with a history of sexual trauma undergoing fertility treatment?

Women survivors of sexual violence who were previously referred for, underwent or were undergoing fertility treatment were invited to participate in an online survey. Respondents were asked about which screening tool they preferred to gather information about the history of sexual violence, and to rate the significance of specific triggers related to fertility treatment.

A total of 155 women responded to the survey. The preferred screening tool for a history of sexual violence was an intake form (76 women [63%]) followed by direct questioning (20 women [16.5%]). Only 11 women (9%) preferred not to be screened for a history of sexual violence. The triggers with the highest intensity were arm and leg fixation during egg retrieval (66.2% and 66.8% of women respectively graded the trigger as 5/5). Past pregnancy was associated with a reduction in the intensity of triggers, but this was of small magnitude (5.8%). Although 65 women (59%) preferred a female physician to carry out fertility-related procedures, most women accepted the treating physician regardless of gender as long as the physician was trained in trauma-informed care.

Not all triggers related to infertility treatment can be completely avoided; however, a discussion with patients about what may pose a trigger and how to decrease the severity of that trigger is important.