PS 4-16
EXPLORING WHY PATIENTS DO NOT PURSUE INFERTILITY TREATMENT AFTER MEETING WITH A REPRODUCTIVE SPECIALIST
Methods: This prospective, longitudinal mixed methods study collected data from 160 subjects over 12 months starting right before their first appointment with a Reproductive Specialist. Subjects were recruited from a reproductive medicine clinic in a state with no insurance mandate to cover infertility testing and treatment. Subjects were assigned to either an interview arm (each member of a couple separately completed interviews and surveys 6 times over 12 months) or a survey arm (each subject completed surveys 2 times over 12 months). We use survey data to examine differences between the respondents who did not pursue medical treatment and those who did. We use content analysis of the interviews to examine how those who opted against treatment characterized their decision-making.
Results: We found no statistically significant differences between respondents who did and did not pursue treatment across key characteristics, including female partner age, decisional conflict score, or household income. However, our sample size was small, and there were some suggestive patterns; for example, of 9 respondents with annual household income <$40,000, only 1 pursued treatment, whereas 79% of respondents with annual income ≥$40,000 underwent at least one treatment. Analysis of interview transcripts shows that limited financial resources are among factors commonly identified as limiting respondents’ ability to pursue treatment. Compared to respondents who pursued treatment, respondents who rejected treatment were (1) more open to becoming parents through adoption and (2) more likely to reject treatments they perceived as unlikely to succeed.
Conclusions: Among people experiencing infertility who seek an appointment with a reproductive specialist, some do not pursue treatment. This appears to be due to several factors, including financial constraints, as well as attitudes towards adoption and perceived likelihood of success. This information may prove useful to clinicians in understanding why patients decide against treatment, and in recognizing patients’ concerns about what medical treatments can and cannot provide.