Research question

Why are women who face poor prognoses for success in assisted reproductive technology (ART) treatment choosing to pursue procedures using their own eggs, despite receiving information that their chances of success are very low.

Design

Cross-sectional study based on an anonymous questionnaire distributed to women aged between 43 and 45 years, undergoing ART using their own oocytes, at six public outpatient fertility clinics and three public in-hospital IVF units in Israel between 2015 and 2016. The main outcome measure was personal estimation of chance to achieve a live birth after the current ART treatment cycle and the cumulative estimated rate after all the treatment cycles the patient intended to undergo.

Results

Response rate was 70.0%, with 91 participants of mean age 43.8 ± 0.7 years. Participants estimated their delivery rates after the next ART treatment cycle at 49.0 ± 31.8% (response rate 93.4%) and their cumulative delivery rates after all the ART treatments they would undergo at 57.7 ± 36.3% (response rate 90.1%). This is significantly higher than the predicted success rates of 5% and 15%, respectively (both P < 0.001), which are based on national register data. Nearly one-half of patients rated themselves as having a better than average chance of conception (47.3%).

Conclusion

Women do not pursue futile treatments because they lack information. Despite being informed of the low success rates of conception using ART treatments, many patients of advanced maternal age have unrealistically high expectations from ART, essentially ignoring their estimated prognosis when deciding on treatment continuation. Future work should examine the psychological reasons behind continuing futile fertility treatments.

中文翻译：

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“幸运的是，我不相信统计数据”：关于女性对无效生育治疗成功机会的理解的调查

研究问题

为什么在辅助生殖技术 (ART) 治疗中面临预后不佳的女性选择使用自己的卵子进行手术，尽管收到的信息表明她们成功的机会非常低。

设计

2015 年至 2016 年间，基于匿名问卷的横断面研究，分发给年龄在 43 至 45 岁之间、使用自己的卵母细胞接受 ART 的女性，在以色列的六个公共门诊生育诊所和三个公共住院 IVF 单位进行。主要结果衡量标准是个人估计在当前 ART 治疗周期后实现活产的机会以及患者打算接受的所有治疗周期后的累积估计率。

结果

响应率为 70.0%，91 名参与者的平均年龄为 43.8 ± 0.7 岁。参与者估计他们在下一个 ART 治疗周期后的分娩率为 49.0 ± 31.8%（响应率 93.4%），他们在接受所有 ART 治疗后的累积分娩率为 57.7 ± 36.3%（响应率 90.1%）。这明显高于基于国家登记数据的预测成功率分别为 5% 和 15%（均P < 0.001）。近一半的患者认为自己的受孕机会高于平均水平 (47.3%)。

结论

女性不会因为缺乏信息而寻求徒劳的治疗。尽管被告知使用 ART 治疗的受孕成功率低，但许多高龄产妇对 ART 抱有不切实际的高期望，在决定继续治疗时基本上忽略了他们估计的预后。未来的工作应该检查持续无效的生育治疗背后的心理原因。