Table 5.

Issues faced by infertile couples and implications for policy and practice.

Issues faced by infertile couples		Implications
	Objective	Policy	Practice
Lack of clear information regarding infertility care pathway, multiplicity of treatments and fractured care	Improve patients' experiences and quality of infertility care services.	1.Establish an updated evidence-based national or territorial health groups' guidelines for infertility management Including •Diagnostic tests, •Therapeutic options psychosocial care, •Follow-up services 2.Develop primary, secondary, and tertiary care coordination ensuring a continuous step-by-step management of patients	1.Healthcare providers should draw up a holistic care plan including all aspects of infertility (medical, psychological and financial) 2.Healthcare providers should benefit from a training on standardized clinical practices, including how to communicate and share information with patients concerning treatment options, cost, duration, and possible outcomes. Provide training on how to manage the emotional burden borne by patients.
Gendered social pressure	Reduce infertility stigma	1.Improve public perception by education, information, and communication campaigns 2.Ensure that availability of services for both female and male causes of infertility	Integrate couple-based counselling, group therapy and support programmes promote public awareness.
Psychological suffering	Reduce psychological stress and burden faced by people with infertility	Enhance inclusion of psychosocial and mental health elements in fertility care	Implement in all infertility care services with mental health care aspects including: •Stress management •Couple counselling and conflict management •Peer support groups •Group therapy
Disruption of daily and professional lives	Decrease patients' struggle and travel time to access treatments	1.Creating other more ART centres across the country 2.Paid leave for infertility treatments	Provide basic services in each Centre and refer patients for complex cases
Financial problems	Enhance financial accessibility	1.Extend insurance coverage to infertility treatments 2.Develop Standardized treatment costs	Inform couples in advance about their financial options to be able to make decisions