Metaphors as communication tools in fertility care and assisted reproductive technologies in Portugal

Objective: Metaphors are ubiquitous in healthcare communication. In fertility care and assisted reproductive technologies (ART), literature highlights a variety of metaphors in public, patient, and professional discourses. This paper explores the construction of figurative discourse in ART settings, aiming to understand how metaphors influence users’ perception and interpretation. Methods: In-depth, semi-structured interviews were conducted with ART patients and medical professionals. Transcripts were thematically analyzed to identify and interpret the use and impact of metaphors in communicative interactions within ART. Results: A total of 74 ART users and 49 health professionals were interviewed. Thematic analysis revealed eight recurrent metaphors across three main themes: Acknowledging reproductive processes (“Chicken's eggs”, “Warm Oven”, “Seed/Flower”); Grasping the embryo's potential (“Pretty embryos”, “Winners”, “Babies”); Naturalizing the strangeness (“Aliens”, “Eskimos/Igloo Children”). Conclusion: Beyond symbolic meanings, metaphors function as communication tools in clinical encounters, combining various types of knowledge and communicative practices. Their use in ART discourses helps render complex medical language intelligible to users, significantly shaping how treatments are communicated, perceived, and experienced. Metaphors can translate clinical concepts into relatable terms, enhancing lay understanding. However, they may also contribute to distress in the event of treatment failure. Practice Implications: By improving understanding of ART procedures and outcomes through the careful use of metaphors, medical professionals can support more effective informed consent or dissent. Training in metaphorical awareness and communication strategies may enhance healthcare providers’ ability to improve patient experiences and promote well-being.