JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):68
Oral Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263630
P-56. Delivering bad news in Assisted Reproduction: How to be assertive?
Patricia Marinho Gramacho1, Bruna Maria Schiavinatto2, Flavia Giacon3
1 Humana Medicina Reprodutiva - Goiânia - GO - Brasil
2 Clinica Fertilitat - Aracaju - SE - Brasil
3 Humana Mater Prime - SÃO PAULO - SP - Brasil
Objective: This paper describes the first lesson of the Enhancing Assisted Reproduction Content project, titled "Delivering Bad News in Assisted Reproduction." The lesson was developed based on clinical observations and psychological practices, aiming to identify the main challenges in communicating bad news between the medical team and patients. As an intervention, a targeted action was proposed for three strategic sectors of a human reproduction clinic: planning/reception, nursing, and medical staff. The starting point was a question common to all groups: "Do you deliver bad news? What kind?" After collecting the responses, a video lesson was presented, offering tools for assertive and empathetic communication during the most critical moments of treatment.
Methods: Descriptive research was adopted as the methodology, characterized by the collection of qualitative data without interference in the analysis, ensuring complete impartiality in describing the experience. The data was collected after a 40-minute video lesson, used as a sensitization tool for three distinct groups: financial planning/reception team (3 professionals), nursing staff (7 professionals), and the medical team (10 professionals).
Results: The clinic's departments showed distinct reactions to the challenges of delivering bad news. The planning/reception team highlighted: (1) Demand for better integration with the medical team, (2) Need for interdisciplinary meetings, (3) Humanization of patient care, (4) Role of clarifying doubts about appointments, (5) Mediating patient-team financial discussions, (6) Institutional pressure to sell treatments, and (7) Training reception staff in assisted reproduction. The nursing staff reported: (1) Excessive patient questioning, (2) High demand for emotional support, (3) Need for psychological support for the team, and (4) Training for reception/call center staff on technical and emotional aspects. The medical team emphasized: (1) Difficulty communicating critical situations (bleeding, pregnancy loss, biological limitations, severe diagnoses), (2) Challenges varying by setting (clinic vs. surgical center), (3) Use of statistics as a tool, (4) Need for legal support, and (5) The perception that recommending IVF can itself be perceived as bad news.
Conclusion: It is concluded that humanized communication in assisted reproduction forms the foundation of therapeutic relationships, profoundly influencing patients' experiences. Effective clinical practice requires combining technical competence with socioemotional skills such as empathy, active listening, and genuine support, together creating a safe environment for facing reproductive challenges. The video lesson proved to be a valuable training tool for professionals, enhancing their ability to communicate assertively at every stage of treatment: from initial diagnosis through follow-up to managing unsuccessful outcomes. This integrated approach allows professionals to perform with technical excellence while preserving the human dimension of care, transforming challenges into opportunities to build trust and resilience.