Why confusion—not cost—is often what stops patients from moving forward

OPINION

This News Digest Story is paid featured content.

By Terry Malanda, RPh

Terry Malanda, RPh has spent more than 30 years working in fertility pharmacy and currently serves patients nationwide through Mandell’s Clinical Pharmacy. Supporting diverse clinic models across the country has given her a broad view into patient behavior. Her conclusion: many patients who hesitate or discontinue fertility treatment were never clearly prepared for what it would demand day to day.

“When expectations are not outlined early, uncertainty grows — and in some cases, commitment weakens.”

Pre-Cycle Preparation Is Emerging as a Retention Variable

Across decades of working with fertility patients, the major themes remain consistent: cost pressure, emotional strain, relationship stress, religious considerations, and the possibility of failure. What stands out is how those concerns escalate when patients do not understand the logistics of treatment before it begins.

We regularly hear from patients who say they did not know what daily medication routines, scheduling demands, or physical effects would feel like until speaking with a pharmacist. Some clinics have structured preparation systems. Others rely heavily on clinical visits that prioritize diagnosis and protocol over daily-life planning. When expectations are not outlined early, uncertainty grows — and in some cases, commitment weakens.

A relative once told me, after three clinic visits, “I learned more in this telephone conversation than in the 3 visits I have had with my clinic.” I had only provided a high-level overview. That experience reflects feedback we hear nationwide.

Unaddressed Knowledge Gaps Amplify Patient Anxiety

When information is incomplete, patients often fill in the blanks themselves. Concerns about medication side effects, long-term health risks, financial exposure, or treatment failure can feel magnified in the absence of structured education.

Not every fear can be eliminated. Many, however, can be contextualized. When patients understand timing, medication purpose, probable side effects, and expected workflow, the unknown becomes defined. Defined processes are less intimidating than ambiguous ones.

Managing expectations is not an accessory to care. It shapes confidence. Confidence influences follow-through.

Keep Patients In-Cycle with Lower Costs and Trusted Support

Medication cost and uncertainty are two of the biggest reasons patients drop off. Mandell’s helps reduce both.

Through its Serono Preferred Pharmacy Partnership, Mandell’s Clinical Pharmacy supports the Fertility Instant Savings Program, helping significantly lower out-of-pocket medication costs so patients are more likely to stay in-cycle.

Mandell’s earns a 4.8-star Google rating and an NPS of 96 by making patient education a priority. Pharmacists are readily available to explain medications and standard fertility procedures, helping patients feel informed.

👉 See how Mandell’s supports patients before and during treatment

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Clinical Precision Without Translation Can Undermine Readiness

Fertility medicine operates in technical language. Patients live in practical reality. When those worlds do not connect clearly, readiness suffers.

A simplified welcome guide that addresses common concerns — supported by testimonials that speak plainly about treatment — can improve comprehension before a cycle begins. Education should establish clarity first, complexity second. Once patients understand the framework, they are better positioned to absorb the details.

Patients who feel informed tend to feel steadier. That steadiness often supports continuity.

“Dropout is not always driven by access alone. Often, it begins with uncertainty.”

Education and Medication Access Work Together to Support Continuity

At Mandell’s, addressing preparation gaps is part of our responsibility. Through pharmacist availability and participation in the Fertility Instant Savings Program, we aim to reduce both financial and informational barriers before and during treatment.

Pharmacists remain available to explain medication use, scheduling, and expectations in accessible terms. That integration of education and medication clarity can reduce preventable hesitation.

Dropout is not always driven by access alone. Often, it begins with uncertainty. Education before the first injection remains one of the most direct opportunities to strengthen patient continuity in fertility care.