Patient centered fertility treatment What is required

Capsule:
Not only patients’ physical condition, but also patients’ treatment preferences, should be taken into account when choosing the right treatment option for an individual patient.

Authors:
Eline Dancet, Ph.D., Thomas M. D’Hooghe, Ph.D., Fulco Van der Veen, Ph.D., Patrik Bossuyt, Ph.D., Walter Sermeus, Ph.D., Ben-Willem Mol, Ph.D., Sjoerd Repping, Ph.D.

Volume 101, Issue 4, Pages 924-926

Abstract:
Not only patients’ physical condition, but also patients’ treatment preferences, should be taken into account when choosing the right treatment option for an individual patient.

  • A well written and provocative article. Several issues arise.
    1. In Canada, tubal surgery is government funded, IVF (except for Quebec) is not. Many patients opt for one and often 2 or 3 more surgical procedures, the cost of which is far from minimal, and which must be borne by an already underfunded health care system just because the treatment is “Free”. Outcomes becaome poorer with each subsequent procedure. Where does patient decision making end under such circumstances?
    2. You state patients often are prepared to overlook maternal and neonatal risks. Society again bears some of the burden of these risks? How can we justify this? In my opinion, this leads to legislative interference by government mandating of what we can and cannot do in the practice of medicine.
    3. Your reference to women accepting the risk of having a child with cognitive or visual impairment over not having a child excludes the partner’s opinion. In 43 years of providing infertility treatment and 32 years of IVF services, I find this to be a very inaccurate statement. The male partner is often totally the opposite, and states openly that he is not prepared to accept any excess risk of an abnormality.
    4. Now that you have presented the issue, why not present a protocol for a study?

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