JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):24
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263546

P-12. Application of the Reproductive Grief Scale for Screening Complicated Grief in a Reproductive Clinic - A Pilot Study

Eliana Junko Morita¹, Matheus Credendio Eiras¹, Patrícia de Castro Gonçalves¹, Sherly Yumi Komori¹

¹CITI Medicina Reprodutiva - São Paulo - SP - Brasil

Objective: In the field of human reproduction, grief is present both in the couple’s past history—marked by numerous unsuccessful attempts—and during treatment, in situations such as low ovarian reserve and few oocytes retrieved, embryos failing to reach D5, embryo transfer with negative β-hCG results, miscarriages, and stillbirths. Grief is part of the loss process and is expected to some degree; however, in certain cases, it exceeds the limits of a normal response and is classified as complicated grief, significantly and persistently affecting the daily lives of these patients. This pilot study aims to assess the feasibility of applying a reproductive grief scale in a reproductive medicine clinic, so that grief can be measured and classified as low or high risk for complicated grief, enabling more targeted interventions. As a secondary objective, we aim to identify the profile of patients who seek support from the clinic’s pregnancy loss care service, to develop more efficient care pathways.
Methods: The study included patients under active follow-up at the pregnancy loss care outpatient service of a reproductive clinic (N=10). Access to the service was solely based on the patient’s wish to receive support after a pregnancy loss at the clinic, with no prior selection or additional charges. A structured questionnaire was administered to collect data on sex, age, number of losses, type of loss, and time since the losses. Additionally, the Reproductive Grief Scale—a validated 5-item questionnaire designed to identify the risk of complicated grief—was applied. Each item scores 0, 1, or 2 points, for a total score ranging from 0 to 10. Scores ≥5 indicate risk of complicated grief. Spearman’s correlation test was used to determine whether the number of losses was associated with the grief scale score.
Results: The mean age of participants (N=10) was 41.44±8.93 years; nine were women and one was a man. Of these, 50% had one loss, 40% had two losses, and 10% had eight or more losses. Scores on the Reproductive Grief Scale were 10, 8, 7, 6, 5, 4, 2, 2, 1, and 1. Thus, 50% of participants were at high risk for complicated grief (≥5 points), while the remaining 50% were at low risk (<5 points). There was no association between the number of losses and the grief scale score (p=0.16). The sample size was insufficient to assess correlations between the type or timing of the loss and the grief score.
Conclusion: This project demonstrates the feasibility and acceptability of applying a structured questionnaire to identify the risk of complicated grief in patients who have experienced reproductive losses. It also showed that 50% of patients who sought the service were experiencing normal grief, highlighting the need for outpatient support in both complicated and non-complicated cases. The male participant’s score differed from his partner’s, raising the possibility that the tool could identify disagreements in grief perception within couples experiencing the same loss, thus helping to design tailored therapeutic plans. Finally, the study showed that the number of losses is not directly related to the grief score. A limitation of this study is its small sample size, which did not allow analysis of the relationship between different types of loss and questionnaire scores. However, by demonstrating feasibility, it paves the way for a long-term study that would enable more robust statistical analyses.