Patient identified factors influencing decisions to seek fertility care: adaptation of a wellness model

ABSTRACT

Objective: To adapt a fertility care wellness model.

Background: Despite availability of a range of diagnostic and therapeutic services for infertility, many do not seek care or discontinue care prior to achieving a live birth. Wellness models can inform research on patient decisions to seek and continue fertility care, as many barriers and drivers are represented within the dimensions of wellness.

Methods: A mixed-methods online survey was completed by 135 people of reproductive age who experienced infertility in the USA. Outcomes included drivers and barriers to seeking or continuing fertility care. Identified factors were compared by treatment history using chi-square and Fisher’s exact tests. Themes and patterns were identified within 174 responses to 6 open-response items through conventional content analysis.

Results: Thematic analysis revealed practical (environmental, financial, and physical) and affective (emotional, social and spiritual) dimensions of wellness in decisions to seek care (67%), with affective rationales more prominent in decisions to return for care (78%).

Conclusion: Decisions to seek fertility care and return after failed treatment integrate practical and affective rationales from financial, physical, environmental, emotional, social and spiritual wellness dimensions. Drivers and barriers within these dimensions should be considered to encourage care seeking and improve patient retention.

KEYWORDS:

• Fertility treatment
• in vitro fertilisation
• treatment seeking behaviour
• decision making
• wellness

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by a 2013–2014 American Society for Reproductive Medicine Research Grant, Birmingham, Alabama and the University of Iowa’s Social Sciences Funding Program, Iowa City, Iowa. Dr Ryan was funded during this research study by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Women’s Reproductive Health Research program: K12-NIH-HD063117.