Written by Dr. Carmel Heeley. Reviewed by Jenny Wordsworth.

I began my career in fertility at sixteen, working as a data entry clerk for a renowned London clinic. 

By twenty, I was in patient-facing roles—first as an administrative assistant, then as a receptionist across several practices. I loved the idea of working in an industry that made a real, positive difference every day to people’s lives. But if I’m honest, I wasn’t quite prepared for what working behind the front desk would actually involve.

I don’t just mean having to discuss private topics—genitalia, sperm, menstruation—with a straight face (though that could be a struggle). What surprised me more was the level of professionalism and emotional labour the role demanded.

Patients came to us for many reasons: routine fertility MOTs (like blood tests and semen analysis), egg or sperm donation, gynaecological procedures, or full fertility treatments like IVF. Most were preparing for the latter and generally fell into two groups: those who had undergone IVF before—often several times—and those who hadn’t. 

The former were often direct and practical, shaped by their earlier experiences. They had, in many ways, become battle-hardened. The latter were usually more tentative—still trying to make sense of what this journey would involve while quickly schooling themselves in the medical processes.

As the first point of contact, I quickly realised that I was responsible for setting the tone. Many patients arrived with a degree of trepidation—not just about the procedures and the chances of success, but about the fact that they were here at all. Most patients had never expected to need medical intervention. Fertility clinics, unlike other healthcare spaces, were wrapped in secrecy, stigma, and often shame, if not just general embarrassment. On top of that, the emotional and physical toll of fertility treatment was heavy, and the outcomes were never guaranteed.

The onus was therefore on those working at the front desk to remove ambiguity, offer reassurance, and clarify what we could from the get-go—to compensate for the uncertainty that so often underscored patients’ journeys. We had to be empathetic, discreet, calm, and kind, all without judgement. I answered basic medical questions (within reason), scheduled appointments, explained treatment and payment plans, and served as a bridge between the patient and the clinical team.

The real emotional weight was borne by the medical staff. Nurses would be on hand at every stage of the medical journey and doctors, too, provided their fair share of emotional support as the ‘keeper of the keys’ when it came to helping patients have families. But outside the consulting rooms, where patients experienced the real challenges, there was the expectation—unspoken from the patients’ side and overtly stated by management—that the rest of patients’ experiences were to be as smooth and stress-free as possible. And the task most often fell on those at the front desk.

For many, the waiting room was “the calm before the storm”. I met patients who were everything from stressed and anxious, unemotional and pragmatic, to hopeful and excited. Many were quiet and guarded while others owned their story, speaking openly about their experiences. I remember one female patient who, on first meeting, strongly advised me to start trying for a baby to avoid her difficulties (I didn’t have the heart to tell her that it didn’t feature in my immediate plans—I was 21—and my boyfriend of one year at the time would have had a heart attack at the suggestion). 

There were moments of joy, excitement, frustration, and heartbreak. One of the hardest parts of the job was witnessing patients try and negotiate all these emotions while at the same time needing to remain somewhat removed. It was the role of the counsellors to help support patients emotionally. Nonetheless, we were still required to possess a heightened emotional awareness and sensitivity, anticipating a range of emotions from patients and avoiding flippancy or triviality at all costs.

I learned this the hard way. One day, after a couple came out of their consultation, I unthinkingly asked, “So, how did it go?”—trying to be friendly. The woman’s eyes filled with tears. She just shook her head. I’d forgotten they were there to find out if their embryo transfer had been successful. I awkwardly handed her the card machine to take payment, the moment burning into my memory.

Even with difficult and jarring moments like these, supporting patients during their most raw and vulnerable moments made the role deeply meaningful. It was a steep learning curve, but one I was grateful for. Even now, more so than ever, I believe that no matter your role in this industry, you can make a difference.

The fertility industry is booming. The desire to have children ensures it will remain essential. I was lucky to work in clinics that prioritised patient wellbeing, but the power dynamic often still tipped toward doctors—often seen as gatekeepers of last chances. This may be an inescapable part of the industry, as is the ultimate focus on success rates, but today there’s real momentum behind making patient experience a priority. The fertility landscape is changing, and patients are now in the driving seat like never before.

The rise of digital health and the cultural shift surrounding women’s wellbeing and agency over their bodies are transforming fertility care. Patients now expect on-demand information and personalised experiences. They want control, the ability to curate their own journeys, and greater transparency surrounding the options available to them. As a result, the new breed of fertility clinic now offers at-home testing and virtual consultations. A myriad of new holistic and reproductive wellness services have also given patients more agency and awareness over their fertility health and wellbeing, while making their journeys less clinical.

Companies like OVUM are helping lead that change, introducing services and supplements that support reproductive wellness in broader ways. Female-led startups are putting patients, and especially women, at the centre of their business models and mission statements. They are reframing fertility as something to be understood, not feared—something individuals can take ownership of, rather than be overwhelmed by. 

Encouragingly, the conversation is starting to shift away from fertility as a “women’s issue” to an “everybody issue”. Fertility affects everyone, and the more inclusive the conversation becomes, the more supportive clinics can be—for all patients.

I believe these shifts will help break down the taboo that still surrounds fertility and what happens within fertility clinics’ walls. Patients will approach clinics more informed, with less fear and shame. And those of us at the front desk will be better able to support them, because the weight of normalising and demystifying the process won’t fall solely on us.

That, ultimately, can only improve the experience—for patients and for those of us besides them. Because, like death and taxes, infertility is a reality we will always contend with—and while we can’t change that, we can change how we meet it, ensuring patients feel supported, understood, and empowered.