Nordic couples' decision-making processes in anticipation of contacting a fertility clinic

Objective: To explore the decision-making processes of Nordic couples in anticipation of contacting a fertility clinic after experiencing difficulties in conceiving. Method: A retrospective descriptive qualitative study of 22 heterosexual infertile couples recruited from fertility clinics in all five Nordic countries. Results: The process comprises three decisions: (i) accepting that they have a shared problem, (ii) acknowledging the need for more knowledge and (iii) taking action to get help. Subcategories were: (i) infertile or not, maintain the balance in the relationship; (ii) information from social networks and information from the health care system; (iii) having an alternative plan and fear of a wrong decision. The core category was 'negotiation and re-negotiation'. Differences between the countries were found with regard to the time couples waited before contacting a fertility clinic, and in the utilisation of private vs. public clinics. Conclusion: It requires a process of negotiation and re-negotiation for couples to reach a compromise. Furthermore, the decision-making process is influenced by the structure of health care services in respective countries.