Development and initial validation of a fertility experiences questionnaire

F Scarlett Thomas; Joseph B Stanford; Jessica N Sanders; Shawn E Gurtcheff; Mark Gibson; Christina A Porucznik; Sara E Simonsen

doi:10.1186/s12978-015-0054-3

Research Methods Measurement and Statistics

Development and initial validation of a fertility experiences questionnaire

Thomas FS, Stanford JB, Sanders JN, Gurtcheff SE, Gibson M, Porucznik CA, Simonsen SE

Published July 17, 2015 Reproductive health, 12, 62

DOI 10.1186/s12978-015-0054-3 PMID 26184507 PMC PMC4504457

RRM Academy Synopsis

Fertility questionnaire mostly matched one clinic's pregnancy records

A questionnaire for collecting fertility histories agreed with clinic records on several points, in a test with 63 women from one Utah clinic. Pregnancy counts matched the chart for about 8 out of 10 of these women. Ovulation drug use matched less well.

Key Findings

Agreement with medical records was good for intrauterine insemination (kappa 0.64, 95% CI 0.46-0.83) and assisted reproductive technology (kappa 0.74, 95% CI 0.57-0.90).
Agreement was lower for oral ovulation drugs (kappa 0.41, 95% CI 0.21-0.61) and injectable ovulation drugs (kappa 0.21).
During their time as patients at the clinic, the pregnancy count matched for 50 women (79.4%), with kappa 0.65. Nine women (14.3%) described more pregnancies in their interview than the chart listed.
During that time, the live birth count matched for 43 women (68.3%), with kappa 0.55. Twelve women (19%) described more live births in their interview than the chart listed.
Time to pregnancy correlated at 0.77 (95% CI 0.55-0.88) in 29 women. Time at risk for pregnancy correlated at 0.42 (95% CI 0.10-0.66) in 35 women.

Interpretation

This validation study checked women's reported fertility histories against chart review at one specialty clinic in Utah. All 63 women were first seen there in 2004, and most were highly educated. The authors note that about half the charts lacked detail on time trying to conceive, so they did not treat the chart as a gold standard for that measure. The findings support further validation in prospective studies.

RRM Context

Fertility awareness charting records fertile days and pregnancy events as they happen. A couple's history then rests on the chart. In this study, recalled time at risk for pregnancy correlated at 0.42 with clinic notes. Written answers were often unclear, so the authors added a phone interview. Research on restorative care, including Creighton and NaProTechnology outcomes, depends on accurate histories like these.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

Many women throughout the world have history of subfertility (resolved or unresolved), but much remains unknown about services and treatments chosen.

Methods

We developed a mixed-mode fertility experiences questionnaire (FEQ) in 2009 through literature review and iterative pilot work to optimize question format and mode of administration. The focus of the FEQ is to collect data retrospectively on time at risk for pregnancy, fertility treatments received and declined, pregnancy, time to pregnancy and pregnancy outcomes. We conducted a validation of key elements of the FEQ with comparison to medical records in 2009 and 2010. The validation sample was selected from women initially seen at a specialized fertility treatment center in Utah in 2004.

Results

The FEQ was optimized with two components: 1) written (paper or web-based), self-administered, followed by 2) telephone- administered questions. In 63 patients analyzed, high levels of correlation were identified between patient self-report and medical records for the use of intrauterine insemination and assisted reproductive technology, pregnancy and live birth histories, time at risk for pregnancy and time to pregnancy. There was low correlation between medical records and self-report for the use of oral ovulation drugs and injectable ovulation drugs. Compared to the medical record, the FEQ was over 90% sensitive for all elements, except injectable ovulation drugs (70% sensitivity).

Conclusions

The FEQ accurately captured elements of fertility treatment history at 5-6 years after the first visit to a specialty clinic.

Topics

Research Methods Measurement and Statistics Instrument Development and Validation

Research Methods › Measurement and Statistics › Instrument Development and Validation

F Scarlett Thomas, Joseph B Stanford, Jessica N Sanders, Shawn E Gurtcheff, Mark Gibson, Christina A Porucznik, Sara E Simonsen

Joe Stanford, Joey Stanford, J Stanford, Jess Sanders, J Sanders, S Gurtcheff, M Gibson, C Porucznik, S Simonsen

PMID 26184507 26184507 DOI 10.1186/s12978-015-0054-3 10.1186/s12978-015-0054-3 Thomas et al. 2015, Thomas 2015

Development and initial validation of a fertility experiences questionnaire

Fertility questionnaire mostly matched one clinic's pregnancy records

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

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