# The end-of-treatment process in medically assisted reproduction: a qualitative study of healthcare professionals’ views

## TL;DR

This study explores how healthcare professionals define and manage the end of medically assisted reproduction treatments, highlighting the complexity and factors involved in this process.

## Contribution

The study provides new insights into healthcare professionals' perspectives on defining and managing the end of medically assisted reproduction treatments.

## Key findings

- The end of treatment is influenced by contextual and proximal factors that interact with each other.
- Healthcare providers use spontaneous strategies to manage the end of treatment, leading to varied outcomes.
- The study highlights the importance of end-of-treatment management in clinical practice.

## Abstract

In the medically assisted reproduction (MAR) pathway, one of the most complex phases is the end of the treatment. Unlike other medical contexts, there is no biological endpoint in the MAR setting. This absence makes the decision to end MAR treatment extremely challenging for both patients and healthcare professionals. Accordingly, our research aimed to examine the process related to the end of MAR treatment, as devised by healthcare professionals. Our sample included physicians, biologists, and psychologists aged ≥18 years with specialised training in assisted reproduction. Data were collected through four focus groups (in February–May 2023), focusing on the topic of the end of treatment (EoT) and its definition. Data were collected and analysed according to the principles of Grounded Theory. The findings shed light on the attributes and components related to the end of the treatment process. The central category “the end of treatment” consists of a definition of what is considered the end of treatment and the associated decision-making process. In the phase leading up to the EoT, the process is influenced by contextual and proximal factors, which interact and influence each other. To cope with and manage the EoT, healthcare providers adopt spontaneous strategies that lead to positive or negative outcomes. End-of-treatment management is a key facet of clinical practice. This contribution increased knowledge about EoT and highlighted healthcare professionals’ perspectives, which should be considered for the implementation of best practice points and respect for patients’ rights to the highest attainable standard of mental and physical health.

One of the most complex phases of the Medically Assisted Procreation (MAR) pathway is the end of treatment. Although this issue is fundamental, to date there is a lack of data on it. The research question of this study was: “How do healthcare professionals define and manage the end of MAR treatment?” Physicians, psychologists, and biologists took part in four focus groups. These groups focused on the topic of ending treatment, its definition, and management. We applied the Grounded Theory methodology to analyse the focus group transcripts. This theory allows us to explore an unexplored phenomenon and build a theory from the data. The end of treatment occurs when patients terminate MAR treatments. It is influenced by contextual and proximal factors. Through different strategies, it leads to negative or positive outcomes. End-of-treatment management is a key facet of clinical practice. These findings may improve the implementation of best practice points.