Both weight loss and OCP use result in significant improvements in several physical and mental domains related to quality of life, depressive symptoms, and anxiety disorders, and combined therapies offer further benefits in overweight/obese women with PCOS.
OBJECTIVE
To assess reproductive choices of US reproductive age women and factors that influence consideration of elective egg freezing (EF).
DESIGN
Cross-sectional Internet based survey of 1000 women
METHODS
An anonymous 63-item self-administered questionnaire was distributed to a representative cross section of reproductive age women age 21–45, stratified by age=35. Half of the sample had at least 1 child, while the remaining expressed desire to have children. Ordinal logistic regression was performed to characterize the association of population characteristics and reproductive knowledge with likelihood to consider EF. Willingness to pay was assessed using a linear prediction model which calculated dollar amounts at varying success rates.
RESULTS
Overall, 87.2% of the sample reported awareness of EF for fertility preservation, 25% would consider this option, yet only 29.8% knew what the EF process entails. Once informed of the process, 30% of women changed their level of consideration. In a multivariable model, Asian race(OR1.71, CI1.36–2.98), single status(OR1.38, CI1.27–1.53), and infertility(OR2.00, CI1.55–2.43) increased the likelihood of considering EF. Women likely to consider egg freezing would be willing to pay $3,811.55 (95% CI $2,862.66 – $4,760.44). If the total cost were $10,000, 91% of the cohort would accept at minimum 50% chance of successful delivery.
CONCLUSION
This study is one of the largest cohorts of reproductive age women in the US addressing reproductive choices and factors associated with the importance of having a biologically-related child and the likelihood of considering EF to preserve fertility. This study provides important insight into the willingness to pay for this elective endeavor.
Objective
To study the association of perinatal outcome and IVF transfer type in a group of infertility patients with standardized treatment and similar prognosis.
Design
Retrospective cohort study.
Setting
University-based infertility center, January 1998 to June 2006.
Patient(s)
Two hundred eighteen IVF pregnancies after fresh embryo transfer (ET); 122 IVF pregnancies after frozen ET.
Intervention(s)
Assessment of perinatal outcome in fresh versus frozen ET pregnancies.
Main Outcome Measure(s)
Pregnancy outcomes after fresh versus frozen embryo transfer (ET). Primary outcome was a composite of three events: preterm delivery, intrauterine growth restriction, or low birth weight. Secondary outcomes were subtypes of pregnancy loss. Associations were assessed using multivariate logistic regression.
Result(s)
The final sample included 340 pregnancies: 218 fresh and 122 frozen ETs. Singleton pregnancy was less likely after transfer of fresh embryos (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.23–0.67), and pregnancies after fresh ET were more likely to end in first-trimester loss (OR 1.82, 95% CI 1.05–3.13). Composite adverse outcome after transfer of fresh (44.0%) versus frozen (32.6%) embryos was higher (OR 1.52, 95% CI 0.90–2.56) and was strongly associated with twin gestation (OR 23.82, 95% CI 11.16–50.82).
Conclusion(s)
Perinatal morbidity is higher in IVF pregnancies conceived after a fresh ET compared with a frozen ET. Although some differences are related to conception with twin gestations, these findings suggest that adverse outcomes may be related to differences in IVF procedures.
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