Comparing patients’ and clinicians’ perceptions of elective single embryo transfer using the attitudes to a twin IVF pregnancy scale (ATIPS)

Abstract

Background This study evaluated a questionnaire originally developed for use with health professionals to explore and compare patients' and clinicians' perceptions of elective single embryo transfer and twin births. Methods IVF clinicians and patients attending an independent Fertility clinic were surveyed using the Attitudes to a twin birth scale (ATIPS) comprising two subscales: attitudes to twins (A-Twin) and attitudes to elective single embryo transfer (A-SET). After refinement total sample scores showed both subscales were reliable with Cronbach's alpha >0.8 and item-total correlations >0.35. Results Questionnaires were completed by 100 female IVF patients and 17 IVF clinicians. A-Twin subscale scores indicated neither the IVF clinicians nor female IVF patients demonstrated very positive attitudes to a twin birth although the IVF female patients were more in favour (t=5.29, n=117, p=<0.001). Responses suggest both groups would benefit from increased information about the risks of a twin birth for the baby. First cycle IVF female patients were significantly more positive about eSET (z=3.94, n=100, p=<0.001). Clinicians perceive both their colleagues' and female patients' negativity towards eSET; suggesting a role for education. Conclusions This study found the ATIPS to be a reliable measure which could be useful in evaluating interventions to promote single embryo transfer.

Prevention of in vitro fertilization twins should focus on maximizing single embryo transfer versus twins are an acceptable complication of in vitro fertilization

“…A majority of couples undergoing infertility treatments consider twins the best outcome (28,33,(62)(63)(64)(65)(66)(67). Whatever their geographic origin, U.S., Europe, Australia, or Africa, more than 50% prefer to have twins, because they want their children to have a sibling, they have a positive attitude towards having twins, they want to have as few treatments as possible (64,68), they have long-time infertility (65) and they have fears regarding the female partner's age (64).…”

“…Whatever their geographic origin, U.S., Europe, Australia, or Africa, more than 50% prefer to have twins, because they want their children to have a sibling, they have a positive attitude towards having twins, they want to have as few treatments as possible (64,68), they have long-time infertility (65) and they have fears regarding the female partner's age (64). Being nulliparous and desiring to limit infertility treatment costs are also reasons to prefer twins (28,66). In one study, neither the woman's age nor the degree of education had an influence on the desire for twins (66).…”

“…Being nulliparous and desiring to limit infertility treatment costs are also reasons to prefer twins (28,66). In one study, neither the woman's age nor the degree of education had an influence on the desire for twins (66).…”

Time-Lapse Imaging of Preimplantation Embryos

“…The avoidance of eSET by patients and physicians is driven primarily by the desire to increase the chance of becoming pregnant. Wider acceptance of eSET is hindered by many factors including attitudes toward the practice [12][13][14] and limitations in reproductive technologies. If these limitations could be overcome, eSET could become more widespread, allowing safer outcomes for more patients.…”

Comparação entre uma transferência eletiva de dois embriões e duas transferências eletivas sequenciais de um embrião: impacto nas taxas de sucesso e de gestação múltipla

“…Tais aspectos exigem da equipe médica agilidade e eficácia na tentativa de se obter sucesso em menor tempo possível, representando muitas vezes um obstáculo para a eSET sequencial (Ezugwu and der Burg, 2015), uma vez que a literatura consagra que a transferência de dois embriões (DET, do inglês double embryo transfer) em um único ciclo de tratamento resulta em taxa de sucesso superior à da transferência de um único embrião, quando o bom prognóstico clínico do casal não é levado em consideração (Baruffi et al, 2009;Fujimoto et al, 2015). (Rai et al, 2011). A educação do paciente em relação à morbidade e mortalidade materna e neonatal decorrente das gestações gemelares, assim como nos custos destas condições, é efetiva em reduzir a preferência por gêmeos entre os casais em tratamento (Murray et al, 2004;Hope and Rombauts, 2010 …”