TABLE A1.

Topics and subtopics used to classify strong types of misunderstandings.

Topics and sub-topics
(A) Bureaucratic topics: Country and center rules
Country rules	• Regulations in egg donation and heterologous insemination (Italy) • Regulations in vitro fertilization (Italy) • Identification of a foreign country allowing egg donation
Center rules	• Coordination • Treatment costs • Contact methods
B. Treatment topics: Timing and procedures
Timing	• Examinations (spermiogram, blood test, fallopian tubes) • Waiting list duration • Medical visits
Procedures	• After getting pregnant • Treatments (sperm freezing, embryo transfer, stimulation) • Assessment of treatment options (egg and/or sperm donation) • In a foreign medical center • Informed consent compilation • Monitoring (number of patients, number of visits before embryo transfer or stimulation cycles of insemination)
(C) Clinical consultation topics: Medical information
	• Assessment of current medical condition • Results of the fallopian tubes examination • Issues related to ovodonation • Issues related to ovulation and menstrual cycle • Issues related to embryo transfer • Issues related to (natural) insemination • Issues related to intrauterine pregnancy • Issues related to heterologous fecundation • Issues related to examinations • Fertility rate • Terminological issues (embryo freezing, karyotype, antagonist stimulation, follow up)
(D) History-taking topics
	• Biographical information (location of couple’s provenience, marital status, patients’ age) • Familiar anamnestic information (parents’ menopause threshold) • Patients’ anamnestic information (menstrual cramps and/or menstrual cycle, previous pregnancies, male sexual problems, sexual intercourse, other health issues) • Previous examinations (sperm test, blood test, breast ultrasound examination) • Relevant documentation • Drug-taking (identification or dosage) • Previous access to a different medical center (discussion of previous treatment place, discussion of clinical issues in another center) • Previous treatment (in vitro fertilization, interruption of a treatment)
(E) Emotional topics: Concerns and complaints
Concerns	• Ovulation and menstrual cycle • Preventive measures related to embryo transfer or stimulation cycles of insemination • Stress caused by the treatment process • Complications of heterologous fecundation (due to fibromas) • Medical limitations
Complaints	• Financial values in another medical center • Treatment in another medical center (overtreatment, embryo procedure, sperm freezing)
(F) Rapport-building topics
	• Previous contact and presentation • Mutual acquaintances • Informal comments and jokes