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Art in Endometriosis

Patient satisfaction concerning assisted reproductive technology treatments in moderate to severe endometriosis

, , , , &
Pages 798-803 | Received 17 Jan 2014, Accepted 04 Jun 2014, Published online: 04 Jul 2014
 

Abstract

A prospective observational cohort study was performed to examine patient satisfaction after one Assisted Reproductive Technology (ART) treatment cycle in moderate to severe endometriosis patients. From May 2012 till September 2013, 25 patients with surgically proven endometriosis stage III-IV were included per group and received intrauterine insemination (IUI), in vitro fertilization (IVF) or IVF preceded by long-term pituitary down-regulation (IVF-ultralong). The median patient satisfaction scores were 8.3, 7.9 and 8.0 in patients receiving IUI (n =22), IVF (n =24) and IVF-ultralong (n =23), respectively (p =0.89). Both deterioration in pain and quality-of-life could not be identified as determinants of decreased patient satisfaction scores. Satisfaction was higher in women receiving their first ART treatment attempt (p =0.002), after treatment accomplishment (p =0.04) and after a positive pregnancy test (p =0.04). A median satisfaction score concerning preceding long term pituitary down-regulation of 6.1 (IVF-ultralong n =25, IUI n =8) was reported. Only three patients would refrain from this preceding therapy in a next treatment attempt. We concluded that patient satisfaction scores were comparable between the three different ART treatments. Since patient satisfaction was in particular dependent on treatment outcomes, it is recommended to compare those three ART treatments in a randomized controlled trial investigating the efficacy, safety and cost-effectiveness.

Chinese abstract

我们对中-重度子宫内膜异位症患者一个周期辅助生殖技术(Assisted Reproductive Technology,ART)后的满意度进行了一项前瞻性观察性队列研究。宫腔内人工授精组(intrauterine insemination,IUI)、体外受精组(in vitro fertilization,IVF)和长期垂体降调节后体外受精组(IVF-超长)每组均收录25名从2012年5月至2013年9月手术确诊为子宫内膜异位症III-IV期患者。三组患者的平均满意度分值分别为:IUI 8.3(n=22)、IVF 7.9(n=24)和IVF-超长 8.0(n=23),p=0.89。疼痛程度及生活质量的恶化均不能作为降低患者满意度分值的决定因素。首次ART患者(p=0.002)、ART成功的患者(p=0.04)和妊娠阳性患者(p=0.04)的满意度分值均高。先进行长期垂体降调节患者的平均满意度为6.1(IVF-超长,n=25,IUI,n=8),且只有三名患者不愿在下一次ART中进行长期垂体降调节。我们总结,三组ART治疗组患者的满意度分值相当。因为患者的满意度与治疗结果关系密切,所以建议采用随机对照试验来研究三种ART治疗方法的有效性、安全性和成本效益。

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