Article type
Abstract
Background: In recent years, in assisted reproduction (ART) programmes, both the rate of live births and also the rate of multiple pregnancies has increased, along with their associated risks. The more embryos transferred, the higher the pregnancy rate and the multiple-pregnancy rate. Shared decision making regarding the number of embryos to be transferred is a big challenge for both patients and healthcare providers. Patients do not always completely understand or feel totally satisfied with the information received to make an informed decision. And sometimes, even doctors are not convinced about the benefits of an elective single-embryo transfer (e-SET).
Objectives: To identify the barriers doctors have in recommending e-SET. This information could be relevant for developing a decision aid to improve the knowledge translation to patients.
Methods: A cross-sectional survey. The participants were medical doctors who are members of the Argentine Society of Reproductive Medicine. After piloting the survey, it was sent by mail and administered through SurveyMonkey. A reminder was sent every week for 3 weeks.
Results: A total of 279 of 619 physicians, all specialists in reproductive medicine replied to the anonymous survey. Main reasons for not offering e-SET to their patients, were that they value achieving a pregnancy higher than the negative aspects of a complication (57.1%), and also that the pregnancy rate with e-SETs could be low (42.4%). Regarding the responsibility of the decision about the number of embryos to transfer, 76.7% thought that patients and doctors should make the decision together, while 22.9% thought that it should be decided by the doctor alone. 58.4% thought that the complications of multiple pregnancies should be discussed more and 93.3% would like to have a formal decision aid to help with counselling.
Conclusions: Currently there are no decision aids used globally about this topic. This survey shows some unilateral decisions taken by doctors in this field. This information could be extremely useful in developing a tool that helps in the shared-decision process.
Objectives: To identify the barriers doctors have in recommending e-SET. This information could be relevant for developing a decision aid to improve the knowledge translation to patients.
Methods: A cross-sectional survey. The participants were medical doctors who are members of the Argentine Society of Reproductive Medicine. After piloting the survey, it was sent by mail and administered through SurveyMonkey. A reminder was sent every week for 3 weeks.
Results: A total of 279 of 619 physicians, all specialists in reproductive medicine replied to the anonymous survey. Main reasons for not offering e-SET to their patients, were that they value achieving a pregnancy higher than the negative aspects of a complication (57.1%), and also that the pregnancy rate with e-SETs could be low (42.4%). Regarding the responsibility of the decision about the number of embryos to transfer, 76.7% thought that patients and doctors should make the decision together, while 22.9% thought that it should be decided by the doctor alone. 58.4% thought that the complications of multiple pregnancies should be discussed more and 93.3% would like to have a formal decision aid to help with counselling.
Conclusions: Currently there are no decision aids used globally about this topic. This survey shows some unilateral decisions taken by doctors in this field. This information could be extremely useful in developing a tool that helps in the shared-decision process.