BACKGROUND: Elective single embryo transfer (eSET) enables the prevention of multiple pregnancies after in vitro fertilization (IVF). However, in Europe, the multiple pregnancy rate after IVF remains stable at approximately 23%, with SET occurring in 15% of all IVF cycles. In most European clinics, the decision for the number of embryos transferred is established through a form of shared decision-making between patients and professionals. The aim of this study is to explore factors influencing this decision, in particular factors preventing eSET use. METHODS: We performed explorative, semi-structured, in-depth interviews, based on two theoretical models. The interviews were performed among 19 Dutch IVF professionals and 20 patients who had just undergone IVF or were on the waiting list for IVF. The interviews were fully transcribed and two researchers independently scored the factors according to the models. RESULTS: We identified a wide variety of factors, potentially influencing eSET use: 37 with the professionals and 26 among the patients. Examples of factors mentioned by both patients and professionals were: uncertainty about the eSET technique, couples' lack of knowledge about essential eSET aspects, absence of a reimbursement system which favours eSET, inadequate options to select couples suitable for eSET and inferior cryopreservation success rates. CONCLUSIONS: This study demonstrates that both IVF professionals and patients identify numerous factors preventing eSET use in clinical practice. To estimate the impact of these factors identified, a quantitative confirmation and assessment of the magnitude of the effect is necessary.
BACKGROUND: Elective single embryo transfer (eSET) enables the prevention of multiple pregnancies after in vitro fertilization (IVF). However, in Europe, the multiple pregnancy rate after IVF remains stable at approximately 23%, with SET occurring in 15% of all IVF cycles. In most European clinics, the decision for the number of embryos transferred is established through a form of shared decision-making between patients and professionals. The aim of this study is to explore factors influencing this decision, in particular factors preventing eSET use. METHODS: We performed explorative, semi-structured, in-depth interviews, based on two theoretical models. The interviews were performed among 19 Dutch IVF professionals and 20 patients who had just undergone IVF or were on the waiting list for IVF. The interviews were fully transcribed and two researchers independently scored the factors according to the models. RESULTS: We identified a wide variety of factors, potentially influencing eSET use: 37 with the professionals and 26 among the patients. Examples of factors mentioned by both patients and professionals were: uncertainty about the eSET technique, couples' lack of knowledge about essential eSET aspects, absence of a reimbursement system which favours eSET, inadequate options to select couples suitable for eSET and inferior cryopreservation success rates. CONCLUSIONS: This study demonstrates that both IVF professionals and patients identify numerous factors preventing eSET use in clinical practice. To estimate the impact of these factors identified, a quantitative confirmation and assessment of the magnitude of the effect is necessary.
Authors: Micah J Hill; Kevin S Richter; Ryan J Heitmann; Terrance D Lewis; Alan H DeCherney; James R Graham; Eric Widra; Michael J Levy Journal: Fertil Steril Date: 2013-02-20 Impact factor: 7.329
Authors: Arno van Peperstraten; Willianne Nelen; Richard Grol; Gerhard Zielhuis; Eddy Adang; Peep Stalmeier; Rosella Hermens; Jan Kremer Journal: BMJ Date: 2010-09-30
Authors: Zhihong Yang; Jiaen Liu; Gary S Collins; Shala A Salem; Xiaohong Liu; Sarah S Lyle; Alison C Peck; E Scott Sills; Rifaat D Salem Journal: Mol Cytogenet Date: 2012-05-02 Impact factor: 2.009
Authors: Mirjam M J van Heesch; Gouke J Bonsel; John C M Dumoulin; Johannes L H Evers; Mark Ahbm van der Hoeven; Johan L Severens; Ramon H M Dykgraaf; Fulco van der Veen; Nino Tonch; Willianne L D M Nelen; Piet van Zonneveld; Johannes B van Goudoever; Pieter Tamminga; Katerina Steiner; Corine Koopman-Esseboom; Catharina E M van Beijsterveldt; Dorret I Boomsma; Diana Snellen; Carmen D Dirksen Journal: BMC Pediatr Date: 2010-10-20 Impact factor: 2.125
Authors: Pedro Aa Monteleone; Paula Gmf Petersen; Pedro Fm Peregrino; Juliana Miorin; Alecsandra P Gomes; Mariana G Fujii; Hamilton de Martin; Tatiana Cs Bonetti; Sergio P Gonçalves Journal: JBRA Assist Reprod Date: 2019-08-22