Are health care providers adequately educating couples for embryo disposition decisions

Capsule:
Patients facing difficult decisions regarding disposition of their surplus embryos require further information about their options after treatment to make timely, comfortable, and informed choices.

Authors:
Stacy G. Deniz, M.D., Edward G. Hughes, M.B.Ch.B., M.Sc., Michael S. Neal, B.Sc.(Hon), M.Sc., Mehrnoosh Faghih, M.D., Shilpa Amin, M.D., F.R.C.S.C., Megan Freebury Karnis, M.D.

Volume 105, Issue 3, Pages 684-689

Abstract:

Objective:
To determine the effectiveness of education provided by health care professionals during and after IVF treatment in preparing couples for surplus embryo disposition decisions.

Design:
Cross-sectional survey.

Setting:
University-affiliated fertility center.

Patient(s):
Couples with embryos cryopreserved for more than 2 years.

Intervention(s):
Self-administered questionnaire.

Main Outcome Measure(s):
A Likert scale was used to rate the response to questions about patients’ preparedness to make decisions regarding their surplus embryos.

Result(s):
The survey response rate was 70% (131 of 187). Education provided by health care professionals before initiating treatment met the needs of the majority of participants (n = 86). After treatment, the education received was not adequate to assist couples in making embryo disposition decisions. Of the 127 respondents who provided feedback on their intention for their cryopreserved embryos, 37% (n = 47) had no intention of using cryopreserved embryos for their own reproduction, 24% (n = 30) intended to use embryos for procreation, and the remaining 39% (n = 50) remained undecided regarding their future use of their embryos. Participants with more than 3 years of infertility (n = 49) were most likely to feel conflicted about the decision after treatment.

Conclusion(s):
The education received after treatment was considered inadequate. Couples with a long duration of infertility and those conflicted about final embryo disposition may be appropriate targets for further intervention. More written information and/or counseling services after treatment may help patients make informed and timely decisions regarding their surplus embryos.

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