Ethics and Policy · Reproductive Ethics

Patient attitudes towards the use of autologous cryopreserved embryos for fertility treatment

Adenuga OS, Duthie EA, Cooper A, Davis JB, Schoyer KD, Sandlow J, Strawn EY, Flynn KE

Published September 2017 Fertility and Sterility
DOI 10.1016/j.fertnstert.2017.07.334

RRM Academy Synopsis

Most couples held no strong views on frozen embryos at first

Most patients and partners held no strong views on frozen embryos after a first specialist visit, in an interview study of members of 37 couples. Stronger attitudes were apparent at 12 months. Few participants held objections to embryo disposition firm enough to stop them considering IVF. Finances were the main barrier for most.

Key Findings

  • The authors conclude that after a first appointment, most patients and partners had no strong views about their own frozen embryos.
  • Early on, many participants did not know what frozen embryos were. Some voiced only positive views, some only negative views, and some both.
  • By 12 months, more participants knew the concept and talked about the specific risks and benefits of freezing and storing embryos.
  • Participants who opposed freezing often gave moral or religious reasons. Very few held negative views on embryo disposition firm enough to stop them considering IVF as a treatment option.
  • For most participants, finances and other considerations posed the largest obstacle to going ahead with IVF.

Interpretation

The source is the abstract of a conference presentation. No full text was available. The researchers ran a longitudinal, prospective interview study, meaning they followed people forward and asked open questions. This report is a secondary analysis of interviews with members of 37 couples. The authors call it exploratory, meant to generate hypotheses, with no statistical comparisons. The couples had booked a first visit with an IVF doctor (a reproductive endocrinologist) or a urologist. The abstract reports attitudes and no treatment outcomes.

RRM Context

The couples studied were weighing IVF, which bypasses the reason conception has not happened. Restorative reproductive medicine (RRM) puts that evaluation first, because IVF proceeds without establishing why conception fails. Questions about creating, freezing or storing embryos arise only on the IVF path.

Abstract

Objective

To evaluate couples’ perceptions of frozen embryos and their effect on fertility treatment decision making.

Design

Longitudinal, prospective, qualitative interview study of couples.

Materials and Methods

Members of 37 couples participated in up to 6 semi-structured interviews over 12 months after scheduling an initial consultation with an infertility specialist (IS) - either a reproductive endocrinologist or urologist. Patients and their partners were interviewed separately by trained independent interviewers and were asked about their views on autologous cryopreservation at one-week and 12-months post consult. This is a secondary analysis of the interview data. Facilitated by NVivo analysis software, we categorized each participant’s comments into four categories and provide illustrative quotes for each. An exploratory study using qualitative data, this work was intended to generate hypotheses and inform future research directions rather than to make statistical comparisons.

Results

Initially, many participants expressed that they had no strong feelings regarding the use of autologous cryopreserved embryos, often admitting that they were unaware of what they were, but some participants did express strictly positive, strictly negative, or both positive and negative views (Table). At 12 months, more patients and their partners were familiar with the concept, and more participants discussed specific risks and benefits associated with freezing embryos and their storage. Those who opposed cryopreservation often cited moral or religious objections, but very few had strong enough negative views about embryo disposition to deter them from considering IVF as a treatment option. For most, other considerations, especially finances, were the primary barrier to pursuing IVF.

Conclusions

Most patients and partners did not have strong views about autologous cryopreserved embryos after an initial appointment with an IS. At 12 months, stronger attitudes were apparent, but very few had strong enough negative views about embryo disposition to deter them from considering IVF as a treatment option.

Topics

By this author

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Ethics and Policy › Reproductive Ethics › Embryo Status · Assisted Reproduction › Freezing and Storage › Embryo Freezing and Storage
Elizabeth Ann Duthie, Alexandra L. Cooper, Joseph B. Davis, Kate D. Schoyer, Kathryn E. Flynn
Liz Duthie, Beth Duthie, Betsy Duthie, E Duthie, Alex Cooper, A Cooper, Joe Davis, Joey Davis, J Davis, Catherine Schoyer, Katherine Schoyer, Kathryn Schoyer, K Schoyer, Kathy Flynn, Kate Flynn, K Flynn
DOI 10.1016/j.fertnstert.2017.07.334 10.1016/j.fertnstert.2017.07.334 Adenuga et al. 2017, Adenuga 2017