Saskia Hendriks1, Madelon van Wely2, Thomas M D'Hooghe3, Andreas Meissner2, Femke Mol2, Karen Peeraer4, Sjoerd Repping5, Eline A F Dancet6. 1. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands; Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda MD, USA. 2. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands. 3. Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium. 4. Leuven University Fertility Clinic, Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium. 5. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands. Electronic address: s.repping@amc.uva.nl. 6. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands; Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium.
Abstract
RESEARCH QUESTION: How much do patients with severe infertility and their gynaecologists value genetic parenthood relative to other key treatment characteristics? DESIGN: A discrete choice experiment included the following treatment characteristics: genetic parenthood, pregnancy rate, curing infertility, maternal health, child health and costs. The questionnaire was disseminated between 2015 and 2016 among Dutch and Belgian patients with severe infertility and their gynaecologists. RESULTS: The questionnaire was completed by 173 patients and 111 gynaecologists. When choosing between treatments that varied in safety, effectiveness and costs, the treatment's ability to lead to genetic parenthood did not affect the treatment preference of patients with severe infertility (n = 173). Genetic parenthood affected the treatment preference of gynaecologists (n = 111) less than all other treatment characteristics. Patients indicated that they would switch to a treatment that did not enable genetic parenthood in return for a child health risk reduction of 3.6%, a cost reduction of €3500, an ovarian hyperstimulation risk reduction of 4.6%, a maternal cancer risk reduction of 2.7% or a pregnancy rate increase of 18%. Gynaecologists made similar trade-offs. CONCLUSIONS: While awaiting replication of this study in larger populations, these findings challenge the presumed dominant importance of genetic parenthood. This raises questions about whether donor gametes could be presented as a worthy alternative earlier in treatment trajectories and whether investments in novel treatments enabling genetic parenthood, like in-vitro gametogenesis, are proportional to their future clinical effect. Published by Elsevier Ltd.
RESEARCH QUESTION: How much do patients with severe infertility and their gynaecologists value genetic parenthood relative to other key treatment characteristics? DESIGN: A discrete choice experiment included the following treatment characteristics: genetic parenthood, pregnancy rate, curing infertility, maternal health, child health and costs. The questionnaire was disseminated between 2015 and 2016 among Dutch and Belgian patients with severe infertility and their gynaecologists. RESULTS: The questionnaire was completed by 173 patients and 111 gynaecologists. When choosing between treatments that varied in safety, effectiveness and costs, the treatment's ability to lead to genetic parenthood did not affect the treatment preference of patients with severe infertility (n = 173). Genetic parenthood affected the treatment preference of gynaecologists (n = 111) less than all other treatment characteristics. Patients indicated that they would switch to a treatment that did not enable genetic parenthood in return for a child health risk reduction of 3.6%, a cost reduction of €3500, an ovarian hyperstimulation risk reduction of 4.6%, a maternal cancer risk reduction of 2.7% or a pregnancy rate increase of 18%. Gynaecologists made similar trade-offs. CONCLUSIONS: While awaiting replication of this study in larger populations, these findings challenge the presumed dominant importance of genetic parenthood. This raises questions about whether donor gametes could be presented as a worthy alternative earlier in treatment trajectories and whether investments in novel treatments enabling genetic parenthood, like in-vitro gametogenesis, are proportional to their future clinical effect. Published by Elsevier Ltd.
Entities:
Keywords:
Assisted reproductive techniques; Attitude to health; Decision making; Discrete choice experiment; Genetic parenthood; Social Validity, Research; research; social validity
Authors: Jackson Kirkman-Brown; Carlos Calhaz-Jorge; Eline A F Dancet; Kersti Lundin; Mariana Martins; Kelly Tilleman; Petra Thorn; Nathalie Vermeulen; Lucy Frith Journal: Hum Reprod Open Date: 2022-02-16