Patients' preferences in deciding between intrauterine insemination and expectant management |
| |
Authors: | 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 |
| |
Affiliation: | Department of Obstetrics & Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. pn.steures@amc.uva.nl |
| |
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%. |
| |
Keywords: | intrauterine insemination/preference/subfertility |
本文献已被 PubMed Oxford 等数据库收录! |
|