"I Don`t Believe in Statistics`: Why Do Women Keep Choosing Ineffective Fertility Treatments? - Israeli Fertility Association Conference-Ayala 2017, May 8-9, 2017

Avi Tsafrir ¹ Hananel Holzer ¹ Ariel Revel ² Ariel Weissman ³ Arye Hurwitz ⁴ Michael Gal ¹ Avraham Ben-Chetrit ¹ Amir Weintraub ¹ Talya Miron-Shatz ⁵

¹IVF unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University
²IVF unit, Department of Obstetrics and Gynecology, Hadassah Hebrew University Hospital- Ein Kerem
³IVF Unit- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center
⁴IVF Unit, Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center- Mt Scopus
⁵Center for Medical Decision Making, Ono Academic College

Background:

Many patients, for whom ART treatments are ineffective, persist with them. This results in futile treatments, physical and emotional difficulties to women. Little is known about patients` rationale in this context.

Aim

To study decision making of patients facing poor prognosis ART treatments

Methods:

A questionnaire was anonymously distributed to ART patients aged 43-5 during the years 2015-6.

Results:

Participants were 72 women scheduled for ART treatments using their own oocytes at mean age 43.8±0.7. Participants estimated delivery rates in the next treatment cycle at 48±32%, and cumulative delivery rates after all treatments they will undergo at 62±34%. Only 15% reported they received no information from their providers regarding estimated success rates 41 (59%) women described how their providers estimated their chances. Of those, 24 (58%) said they received a very low estimation of success, and 14 (34%) received verbal descriptions which may be interpreted as less pessimistic. Only three women (7%) claimed they had been given optimistic delivery prospects. 80% responded they would have attempted treatments regardless of any a-priori estimation of outcome. 65% of respondents would like their providers to inform them about estimated success rates even when those are very low. In contrast, 30% would like to receive such information only if they specifically request it.

Conclusion:

Despite being informed, most advanced-age ART patients have extremely unrealistic expectations of ART and ignore their estimated prognosis when making decisions regarding treatments.