Fertility clinics put considerable effort into bringing patients into treatment. Websites, referrals, consultations and the work of building trust all happen before a patient starts their first cycle. But when that cycle ends with a negative pregnancy test, how deliberately have we designed what happens next?
During treatment, patients have a structure around them. There are appointments, scans, medication instructions and messages from the clinic. Then the test is negative, and that structure can disappear at the moment they need it most.
The clinic calls, explains the result and discusses follow-up. But what happens after that conversation, when the patient thinks of the questions they could not ask earlier? Do they know who to contact? Is a review being arranged? Will someone check in, or does the next conversation depend on them finding the energy to start it?
For patients, this is a moment of vulnerability. For clinics, it is also an important moment in a relationship they have invested time and resources in building.
What patients are telling us
The HFEA’s National Patient Survey 2024 gives us a reason to look more closely at this part of care.
Among the aspects of treatment measured, support, including access to counselling, had the lowest satisfaction rating at 69%. Overall satisfaction also differed substantially by outcome: 50% of respondents who did not have a baby were satisfied with their treatment, compared with 88% of those who had a baby or were pregnant. These figures cannot separate the impact of the outcome itself from the experience of care, but they highlight why unsuccessful treatment deserves particular attention.
The written responses give us more detail. Some patients described emotionally difficult waits to speak to their clinic or access support after negative outcomes, including pregnancy loss. Timely, empathetic responses after failed transfers or pregnancy loss were valued, as was continuity through a familiar clinician or named nurse.
There is something very practical in that feedback. Patients want to reach someone, understand what happens next and feel that the clinic still sees them as a person whose care is ongoing.
A completed cycle is not a completed patient relationship
For a busy clinic, the result is one of many things that need attention that day. The team may be supporting patients through egg collections, answering medication questions and preparing others to start treatment, while also finding time for difficult conversations.
A compassionate nurse can have an excellent conversation with a patient and still have no reliable way to ensure that the promised follow-up happens. A doctor may expect a review to be booked, while the patient is waiting for someone to contact them. Everyone can be acting with care, and a gap can still appear between them.
For the patient, that gap can feel like being dropped.
It also matters commercially. If someone wants further treatment but leaves because they feel forgotten, the clinic loses an existing relationship and the opportunity to continue caring for that patient. Investing in patient acquisition while leaving follow-up dependent on individual memory creates an avoidable weakness in the business.
The HFEA findings do not quantify that loss or establish why patients switch clinics. They do, however, identify aspects of care that clinics can improve. Protecting the relationship means looking carefully at what happens between an unsuccessful outcome and the patient’s next decision.
Follow-up needs to be part of the workflow
“Someone should check in” is a fragile process in a busy clinic.
Once the clinical team has reviewed and communicated the result, there should be a clear pathway for the next steps agreed with the patient. That might include a follow-up call, a review appointment, written confirmation of the team’s instructions and access to counselling. Each action needs an owner, and the patient should know what to expect.
A digital platform can carry much of the coordination around this. It can create an assigned follow-up task, offer a route to book the review and make the agreed information available in the portal. It can also show the team when an action remains outstanding.
This takes work off both sides. The patient does not have to remember everything from a difficult conversation, and the nurse does not need a separate spreadsheet of people to check on.
The pathway should also reflect individual preferences. One patient may want a review as soon as possible. Another may want a call the following week. Someone else may ask for space. Recording those wishes allows the team to follow through appropriately, without repeatedly asking the patient to explain what they need.
The patient experience portal needs to understand that something has changed
A patient’s digital experience should reflect the conversation they have just had with the clinic.
If the result is negative but the patient still sees outdated test reminders, irrelevant treatment tasks or generic prompts to book another cycle, the experience feels disconnected. A routine request to rate the clinic can be particularly poorly timed.
After the clinical team confirms the change in care, the patient experience platform should adapt accordingly. Communications can be paused or changed, the agreed next step made visible and an easy route back to the team kept accessible.
Support should also remain easy to find. A patient may not be ready to think about counselling during the result call but want to explore it several days later. They may remember a question after the clinic has closed or want to write down what they hope to discuss at their review.
The portal can give those needs somewhere to go, with clear expectations about how and when the team will respond. These interactions help maintain continuity between conversations.
Clinics should be able to design their own follow-up experience
There will not be one pathway that works for every clinic or every patient.
Some clinics have an in-house counselling team, while others work with external services. Follow-up may sit with a named nurse, a patient coordinator or a wider clinical team. A platform should allow clinics to configure the experience around their services and the standards of care they want to deliver.
That means deciding who follows up, when contact is offered, which resources are shared and what happens if a review remains unbooked. It also means defining which communications can happen automatically and which require a member of the team.
A clinic could, for example, design a pathway where a patient receives a reviewed summary after the result conversation, is offered a review appointment and has a check-in task created for their named coordinator. If the patient asks for space, the team can adapt the pathway and record an agreed time for future contact.
The clinic makes those decisions once, then adjusts them to the individual. Staff should not have to rebuild the process for every patient.
That is how a thoughtful patient experience becomes something a clinic can deliver consistently, even on its busiest days.
Where AI can help
AI has a useful role in reducing the work required to keep that experience connected. Before a follow-up conversation, it could bring together relevant cycle information, previous discussions and questions the patient has raised. Afterwards, it could help prepare a written recap for the team to review and identify the actions that were agreed.
It could also help surface unresolved questions across patient messages. Someone may have mentioned that they do not understand the next step, are worried about costs or have been unable to access counselling. Bringing those details to the appropriate team member can make the next conversation more informed and reduce the need for patients to explain themselves again.
Within the portal, an AI care coordinator could help patients find clinic-approved information, arrange a review or request contact from the right person. Questions requiring clinical judgement, and messages suggesting distress, need a clear route to a person, with the clinical team retaining responsibility for care.
For this to be useful, the coordinator needs context. It needs to know that the result has been communicated, what follow-up has been agreed and whether the patient has asked for contact or space. Without that connection to the clinical workflow, it risks becoming another source of generic communication.
With it, AI could help clinics follow through more consistently while giving staff more time for the conversations that need them.
Give teams visibility without adding another list
For the clinic, the practical question is often simple: who needs our attention today?
Which patients are waiting for a review? Who was promised a call? Who has an unanswered question? Who has said they want to continue treatment but has no next step agreed?
A shared view of those outstanding actions helps teams direct their attention and makes continuity less dependent on one person being at work.
It also gives clinics a better way to understand their own process. They can examine whether agreed follow-ups happen, how long patients wait for reviews and where handovers repeatedly break down. If they want to understand whether better follow-up supports retention, they need to distinguish patients who deliberately pause or end treatment from those who wanted to continue but encountered gaps in care.
That distinction matters. An unbooked appointment alone tells us very little about what a patient wants.
Support should leave room for a pause
A patient who has not booked another appointment may be taking a deliberate break, considering their options or waiting for the clinic to contact them. Silence cannot tell the team which of those is true.
Good digital support should make it easier to understand and respect what has been agreed. Contact preferences, a planned check-in and access to relevant information allow the clinic to remain available without turning every interaction into a prompt to book another cycle.
Some patients will return quickly. Others will choose another provider or decide to end treatment. A well-designed experience needs room for all of those decisions.
For patients who want to continue, the opportunity is to make the route forward clearer. For those who need time, it is to make sure a pause does not feel like being forgotten.
How we are approaching this at wawa
This is the thinking behind the care coordinator we are building at wawa: helping clinics stay connected to patients across the spaces between appointments, treatment cycles and decisions.
Our approach is to combine pathways configured by the clinic with AI that can help coordinate follow-up, bring relevant context to the team and make agreed information and next steps easier for patients to access. The clinic shapes the experience around its services and standards, while the coordinator helps carry the work required to deliver it.
An unsuccessful cycle is an important example because it creates a difficult combination: patients may need more support just as their scheduled contact with the clinic becomes less frequent.
Clinics already invest heavily in earning patients’ trust before treatment. Making it easier to follow through afterwards can help protect that relationship while reducing the administrative burden on the team.
After a negative pregnancy test, a patient may not be ready to decide what comes next. Their clinic should still have a reliable way to be there when they are.
