Patients' preferences in deciding between intrauterine insemination and expectant management
Authors: Steures, Pieternel1; Berkhout, Jidske C.2; Hompes, Peter G.A.1; van der Steeg, Jan Willem1; Bossuyt, Patrick M.M.3; van der Veen, Fulco2; Habbema, J. Dik F.4; Eijkemans, Marinus J.C.4; Mol, Ben W.J.2
Source: Human Reproduction, Volume 20, Number 3, 01 March 2005 , pp. 752-755(4)
Publisher: Oxford University Press
Abstract:BACKGROUND: Intrauterine insemination (IUI) is a commonly used treatment in subfertile couples. We assessed patients' preferences for IUI relative to expectant management. METHODS: Forty subfertile couples were offered scenarios in which the treatment-independent pregnancy chance was varied against a fixed pregnancy chance after IUI without or with controlled ovarian hyperstimulation (COH) of 8% and 12% per cycle, respectively. The treatment-independent pregnancy chance within 12 months was initially set at 100%, and subsequently reduced until couples switched preferences. We also investigated the impact of the risks of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy on couples' preferences. RESULTS: When pregnancy was guaranteed within a year, all couples would opt for expectant management. Most couples switched to IUI without COH at a 60% chance of a treatment-independent pregnancy and to IUI with COH between a 40% and 60% chance. Where the risk of OHSS was set at 10%, a large majority of the couples preferred expectant management to IUI. At a multiple pregnancy risk of 100%, 77% of the couples would still prefer IUI. CONCLUSIONS: The majority of couples prefer IUI with or without COH when the treatment-independent pregnancy chance in the next 12 months is <50% and <40%, respectively. The risk of a multiple pregnancy does not affect their preference for IUI, whereas IUI is rejected when the risk of OHSS exceeds 10%.
Document Type: Research Article
Affiliations: 1: Department of Obstetrics & Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, 2: Centre for Reproductive Medicine and 3: Department of Biostatistics & Epidemiology, Academic Medical Centre, Amsterdam, 4: Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam and
Publication date: 2005-03-01
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.
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- In this Subject: Anatomy & Physiology , Obstetrics & Gynecology
- By this author: Steures, Pieternel ; Berkhout, Jidske C. ; Hompes, Peter G.A. ; van der Steeg, Jan Willem ; Bossuyt, Patrick M.M. ; van der Veen, Fulco ; Habbema, J. Dik F. ; Eijkemans, Marinus J.C. ; Mol, Ben W.J.