Knowledge, Attitudes, and Challenges: Irish General practitioners’ preparedness for publicly funded Assisted Reproductive Technologies

Congratulations to Dr Sarah Petch, Dr Louise Glover, Mr David Crosby and all involved in their important new research study.  Their paper, Knowledge, Attitudes, and Challenges: Irish General practitioners’ preparedness for publicly funded Assisted reproductive technologies, was published in EJOG and the research was also highlighted in The Journal.

Highlights

  • General practitioners (GPs) play a pivotal role in managing infertility in Ireland.
  • Ireland has a new publicly funded assisted reproductive technology (ART) scheme.
  • We investigate GP’s knowledge of fertility and opinions of ART referral criteria.
  • GPs feel the ART access criteria are too narrow and that they need more education.
  • Access to fertility treatment globally remains highly inequitable.

Abstract

Objectives

Global access to assisted reproductive technologies (ART) remains highly inequitable. Until recently, access to ART in Ireland was solely available through private fertility clinics. Publicly funded ART was introduced in September 2023 but eligibility requires patients to meet strict access criteria that include referral by their primary care general practitioner (GP) to the local fertility service. Previous studies report that fertility training amongst doctors, including GPs, is variable and an obstetrics and gynaecology (O&G) rotation is not mandatory for GP trainees in Ireland. This study aimed to investigate GPs’ knowledge of fertility investigations and management, as well as attitudes towards publicly funded ART access criteria.

Study Design

A cross-sectional online survey was distributed to GPs working in Ireland between September 2023 and January 2024. The survey questionnaire explored attitudes to, and knowledge of, ART including the publicly funded access criteria. Responses to free-text questions were qualitatively analysed using content analysis.

Results

The study had 154 respondents, representing approximately 4 % of GPs in Ireland. Three quarters (n = 120, 78 %) of respondents were female, 68 % (n = 105) had completed an O&G training rotation and 72 % (n = 111) had further O&G qualifications. However, 69 % (n = 107) reported that they had no training in subfertility investigation and management, and 34 % (n = 53) were not aware of the access criteria for publicly funded ART prior to completing the survey. Almost all GPs (97 %, n = 149) felt that they would benefit from more education on fertility. Qualitative content analysis generated two themes regarding publicly funded ART: (i) the access criteria are too restrictive and (ii) the workload for GPs will increase.

Conclusions

GPs in Ireland are now being tasked with managing infertility and fertility treatment referrals, but most have not been provided with sufficient training. Our study shows that GPs in Ireland desire broader access criteria for publicly funded ART and better fertility training and education for their own clinical practice.

https://www.ejog.org/article/S0301-2115(24)00431-7/fulltext#%20