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Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study
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 pos...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373702/ https://www.ncbi.nlm.nih.gov/pubmed/37495387 http://dx.doi.org/10.1136/bmjopen-2022-069146 |
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author | Armstrong, Sarah C Vaughan, Emily Lensen, Sarah Caughey, Lucy Farquhar, Cynthia M Pacey, Allan Balen, Adam H Peate, Michelle Wainwright, Elaine |
author_facet | Armstrong, Sarah C Vaughan, Emily Lensen, Sarah Caughey, Lucy Farquhar, Cynthia M Pacey, Allan Balen, Adam H Peate, Michelle Wainwright, Elaine |
author_sort | Armstrong, Sarah C |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10373702 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-103737022023-07-28 Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study Armstrong, Sarah C Vaughan, Emily Lensen, Sarah Caughey, Lucy Farquhar, Cynthia M Pacey, Allan Balen, Adam H Peate, Michelle Wainwright, Elaine BMJ Open Reproductive Medicine 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. BMJ Publishing Group 2023-07-26 /pmc/articles/PMC10373702/ /pubmed/37495387 http://dx.doi.org/10.1136/bmjopen-2022-069146 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Reproductive Medicine Armstrong, Sarah C Vaughan, Emily Lensen, Sarah Caughey, Lucy Farquhar, Cynthia M Pacey, Allan Balen, Adam H Peate, Michelle Wainwright, Elaine Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study |
title | Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study |
title_full | Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study |
title_fullStr | Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study |
title_full_unstemmed | Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study |
title_short | Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study |
title_sort | patient and professional perspectives about using in vitro fertilisation add-ons in the uk and australia: a qualitative study |
topic | Reproductive Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373702/ https://www.ncbi.nlm.nih.gov/pubmed/37495387 http://dx.doi.org/10.1136/bmjopen-2022-069146 |
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