Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study

BMJ Open · 9 authors, 8 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

This qualitative interview study explored the decision-making processes of patients and professionals regarding the use of IVF add-ons. The central finding was that patients' decisions were often driven by hope and the trusted opinion of a professional, while safety, efficacy, and cost were frequently considered secondary concerns.

Full summary

401 CHARS

Professionals reported that while they aimed to avoid financial waste for patients, they felt add-on use was often patient-driven. A key challenge for both groups was applying general evidence-based medicine to the high-stakes, individual context of IVF treatment. The study suggests a need to improve the quality of discourse between patients and professionals regarding informed consent for add-ons.

STUDY TYPE

other

SPECIALTY

obstetrics and gynecology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10373702

Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study

BMJ Open

READ THE FULL PAPER

ABSTRACT

Abstract Objectives In vitro fertilisation (IVF) add-ons are additional procedures offered alongside an IVF cycle with the aim of improving live birth rates. They are controversial because of the paucity of evidence to support their efficacy and safety, alongside the additional financial cost they often pose to patients. Despite this, they are popular. However, there is limited qualitative research regarding their use. The aims of the VALUE Study were to understand the decision-making process surrounding using or recommending add-ons; report sources of information for add-ons; and explore concerns for safety and effectiveness when considering their use. Design ‘VALUE’ is a qualitative semistructured interview study using inductive thematic analysis of anonymised transcriptions. Setting Participants were recruited from a broad geographical spread across the UK and Australia from public and private clinical settings. Participants Patients (n=25) and health professionals (embryologists (n=25) and clinicians (n=24)) were interviewed. A purposive sampling strategy was undertaken. The sampling framework included people having state-subsidised and private cycles, professionals working in public and private sectors, geographical location and professionals of all grades. Results Patients often made decisions about add-ons based on hope, minimising considerations of safety, efficacy or cost, whereas professionals sought the best outcomes for their patients and wanted to avoid them wasting their money. The driving forces behind add-on use differed: for patients, a professional opinion was the most influential reason, whereas for professionals, it was seen as patient driven. For both groups, applying the available evidence to individual circumstances was very challenging, especially in the sphere of IVF medicine, where the stakes are high. Conclusions There is scope to build on the quality of the discourse between patients and professionals. Patients describe valuing their autonomy with add-ons, but for professionals, undertaking informed consent will be critical, no matter where they sit on the spectrum regarding add-ons. Trial registration osf.io/vnyb9. Keywords: QUALITATIVE RESEARCH, Reproductive medicine, Subfertility

CITATION EXPORT

Sarah C Armstrong, Emily Vaughan, Sarah Lensen et al.. Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2022-069146

AUTHORS

9 · 8 CENTRES

Sarah C Armstrong, Emily Vaughan, Sarah Lensen, Lucy Caughey, Cynthia M Farquhar, Allan Pacey, Adam H Balen, Michelle Peate, Elaine Wainwright

1Oncology and Metabolism, The University of Sheffield Faculty of Medicine, Dentistry and Health, Sheffield, UK
2Gynaecology, St Michael's Hospital, Bristol, UK
3Academic Womens Health Unit, University of Bristol Medical School, Bristol, UK
4Department of Obstetrics and Gynaecology, University of Melbourne, Royal Women's Hospital, Melbourne, Victoria, Australia
5University of Auckland, Auckland, New Zealand
6Reproductive Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
7School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
8Department for Health, University of Bath, Bath, UK