JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):197
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263888

P-185. Psychological Referral: The Crucial Role of Physicians and Other Clinical Team Professionals

Flávia Giacon¹, Sherly Yumi Komori²

¹ Mater Prime Clínica de Reprodução Assistida - São Paulo - SP – Brasil
² CITI - Centro de Investigação e Tratamento da Infertilidade - São Paulo - São Paulo - Brasil

Objective: Given the emotional impact of reproductive treatments, psychological referral may be necessary to ensure a contemporary approach that considers patients in their entirety and individuality. The timing of psychological referral is crucial to guarantee that referred patients receive appropriate care. This study aims to highlight the importance of psychological referral, as assertiveness at this stage is determinant for patient acceptance and prompt pursuit of specialized support.
Methods: A literature review was conducted using PubMed, LILACS, and SciELO databases with the descriptors Mental health, Psychological referral, and In vitro fertilization. Studies published between 2015-2025 in Portuguese, English, or Spanish with full-text open access were included. Article selection was based on title analysis without abstract evaluation.
Results: Research underscores the need for mental health attention in reproductive medicine, though the importance and assertiveness of psychological referral remain underdiscussed. Studies show higher anxiety and depression prevalence among assisted reproduction patients compared to the general population. In clinical practice, psychological referrals are primarily made by physicians, though other team members may also initiate or recommend them. Healthcare professionals must recognize common symptoms in this population and know proper referral procedures. Domar et al. (2018) found in a Boston study that many women didn't discuss psychological stressors with physicians, despite stress being a primary concern. Sax and Lawson (2022) demonstrate that adherence to psychological support correlates with trust in the referring physician, reducing mental health stigma and promoting comprehensive care. The inclusion of mental health professionals also reduces emotional burden on medical teams through additional support, decreased patient stress, and direct specialist access. In 2021, the ASRM Committee recommended that reproductive clinics include "mental health professionals experienced in reproductive issues" as a minimum standard. Referrals can be made to either in-house psychologists or external partners, with studies showing this integration increases patient satisfaction, reduces psychological distress, and improves treatment adherence. A study limitation was using only freely available articles, potentially excluding relevant publications.
Conclusion: While professionals should be empathetic, they must be trained to identify symptoms and refer assertively. Qualified professionals should assess psychotherapy needs and benefits while providing emotional support. Considering various referral motivations, the referring professional's role is crucial for timely psychological access. Assertive referral ensures patients receive specialized assessment and appropriate interventions.