By Anthony Ryb

BICA London group coordinator, accredited fertility counsellor and senior accredited bereavement and grief therapist.

Appeared in BioNews 1048

The announcement made a couple of weeks ago that from Monday 11 May 2020, fertility clinics can apply to reopen, has prompted a huge surge of relief and hope within the industry and, even more so, among the patients for whom treatment may have been postponed or put on hold, seemingly indefinitely.

However, many of the people seeking treatment I have been working with, inadvertently refer to 11 May as the date that treatment will resume. To them, I stress that this date marks when clinics can apply to reopen, if they choose, to which they often reply,  'Ah yes, that's what I meant'.

Fertility counselling provides a safe space for managing expectations, and for offloading and unburdening oneself of the emotions and feelings whirling around in these uncertain times, so that we might feel supported and hopefully develop strategies that can help us move forward.

Going into lockdown provoked anger, confusion, despair, distress, confusion in addition to new layers and levels of helplessness, powerlessness and uncertainty to those that already accompany fertility treatment. The overriding concern hadn't changed, however, and remained the arch-nemesis of all fertility treatment, namely, time. Time was now on hold.

That said, during its initial phase, lockdown appeared to provide some levelling and a measure of comfort for some. Suddenly almost everyone was in the same boat, all feeling some element of loss and uncertainty. We were all at risk in one way or another and everyone's world had changed. That was comforting for some. Additionally, no excuses were required to avoid social gatherings or to explain why you might not be drinking. 

Now, with clinics applying to reopen, there is new hope, but also uncertainty. When will the clinic's applications be submitted? When will this be accepted or rejected? How long will it take the clinic to reopen and who then has priority? What is the waiting time for your treatment?

Many clinics haven't been communicating very clearly with their patients (or staff) over the past couple of months, and this means that some people might be receiving a call out of the blue, likely leading to mixed emotions.

Some patients I have spoken with have indicated concerns around not knowing what tests they may have to repeat, when and where these will be done, how long the results will take to come through and, most critically, whether their results may have changed, or their fertility levels compromised, possibly causing further delays or at worse cancellation of their treatment.

Many have lost their jobs along with the maternity packages these provided, leading to financial concerns. Others may be hesitant to resume treatment, having lost people close to them, may be cautious about going through with treatment with the looming possibility of a second wave or further health scares and lockdowns.

On the clinic's side, many staff were released from service, let go or fired. They may themselves be harbouring a range of emotions as they are called back into work and it might be useful for them to have access to counselling too.

Likewise, some staff members may have moved over to support the NHS or other medical centres and may be witnessing traumatic incidents, they too may benefit from knowing they have support available to them.

Two years ago, in an article I wrote for BioNews, I explained why I felt counselling should be mandatory for everyone going through fertility treatment. Over the last two years, the Human Fertilisation and Embryology Authority (HFEA), along with the British Infertility Counselling Association (BICA) have increased awareness and improved the delivery and overall support and care available for people seeking fertility treatment. These changes are encouraging and hopefully mark that start of further improvements.

I do appreciate that not everyone feels counselling is a priority. Many will be impatient, wanting to get on with things with as few hurdles as possible but it is important that we provide the emotional support to make this return sustainable for all involved.  

The HFEA has been updating its website throughout this lockdown period, advising when possible on all dimensions of the conversations that have been, and continue to go on, behind the scenes to enable this sector to reopen its doors.

Communication is key, and this is what counselling is all about. As counsellors, we will listen and support. Whoever you are, whatever your story, and no matter what your fear or worry, you will be in safe and confidential hands.

I do hope that alongside the opening of their doors and tills, clinics will be open to provide counselling support to both patients and staff. If ever there was a time to promote and make use of this precious resource, it's now. 

I sincerely wish the sector, everyone working within it and using it, the very best.