How do IVF patients interpret claims about fertility treatments? A randomised survey experiment

Abstract

Trials evaluating the efficacy of IVF and various treatment options often focus on upstream outcome measures, improvements which may not translate into clinical outcome improvements. A cross-sectional online survey was distributed globally among IVF patients. Respondents were randomised to view one of 16 statements about a hypothetical IVF treatment option called ‘FertiSure’, stated to improve one of four upstream outcomes. Statements varied in whether they contained information stating that FertiSure was not proven to improve live-birth rates and about potential risks. Many patients inferred that improvements in upstream outcomes would result in improvements in the probability of live-birth. Nearly 80% of respondents were willing to use FertiSure. Respondents told that FertiSure was not proven to improve live-birth rates and were less willing to use FertiSure. More respondents agreed that FertiSure may pose a risk to patients when they were told this was the case. However, this did not affect their willingness to use FertiSure. Interestingly, 34% of respondents believed FertiSure would not improve the probability of live-birth but were still willing to use it. These results have implications for IVF clinic websites and information about treatment options which may not routinely contain statements about the limited evidence-base and possible risks.

Keywords:

• Surrogate outcomes
• upstream outcomes
• IVF
• IVF add-ons
• assisted reproduction

Acknowledgements

The authors wish to thank the IVF patients who contributed to the survey piloting and gave generous feedback; Sarah Smith, Elizabeth Tindle-May and Katy Lindemann.

Author contributions

S.L. conceived the idea for the survey. All authors contributed to the survey design. J.W. and M.C. analysed the data and M.C. drafted the manuscript. All authors contributed to the interpretation of data and manuscript preparation.

Disclosure statement

A.P. declares that he provides fertility services at Melbourne IVF (part of Virtus Health). SL, MC report no conflict of interest.

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.

Additional information

Funding

SL is supported by a McKenzie Postdoctoral Fellowship Grant [University of Melbourne] and the NHMRC through an Investigator Grant [APP1195189]. J.W. reports grants from [Wellcome Trust] during the conduct of the study.