“It is our everyday life”. A Swiss interview-based study on care professionals’ experiences in assisting older patients to conceive with medically assisted reproduction

Abstract Background Medically assisted reproduction (MAR) has expanded the chances people have to reproduce, but it has also raised a number of ethical issues on how to use these technologies. One of the most relevant doubts concerns the possibility of granting access to MAR to older aspiring parents, considering that an increasing number of people have children at an advance parental age (APA). This generates not only abstract theoretical questions, but also concrete challenges and moral doubts for care professionals in their daily work. Methods To investigate these issues, we conducted a qualitative exploratory study. After developing a semi-structured interview guide, we recruited and interviewed 15 care professionals in Switzerland working with older patients trying to conceive with MAR. Results Through applied thematic analysis and collaborative auditing, we identified relevant themes in our data. First, our participants emphasised that they often work with older patients, who are part of the everyday work for MAR professionals. We then showed that professionals perceive older patients as particularly ‘on edge’ and thus have to adjust their work accordingly. Third we investigated the specificities that interacting with older patients during MAR treatment entail, including the need to be realistic about chances but also empathetic about emotional investment. Finally, we identified the struggles of professionals in assessing their patients as potential future parents. Conclusions Our results show that professionals often perceive older patients as unaware of their advanced reproductive age, thus raising the question whether public health campaigns should better convey this message. It is also important to reflect on the struggles that professionals face in breaking bad news and balancing the desire to help older patients without fuelling false hopes. This shows the need of more widespread discussion and guidance on how to best provide care to this growing group of patients.