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J Assist Reprod Genet. 2018 Jan;35(1):49-59. doi: 10.1007/s10815-017-1081-5. Epub 2017 Nov 9.

Medical egg freezing: the importance of a patient-centered approach to fertility preservation.

Author information

1
Department of Anthropology, Yale University, 10 Sachem Street, New Haven, CT, 06520, USA. marcia.inhorn@yale.edu.
2
Department of Nursing, University of Haifa, 3498838, Haifa, Israel.
3
Stanford Fertility and Reproductive Medicine Center, Stanford University, 1195 W. Fremont Ave., Sunnyvale, CA, 94087, USA.
4
Shady Grove Fertility, 9600 Blackwell Road, Rockville, MD, 20850, USA.
5
Center for Human Reproduction, 21 E. 69th Street, New York, NY, 10021, USA.
6
Department of Obstetrics and Gynecology, IVF and Fertility Unit, Sheba Medical Center, 1 Emek Ha'ella St, 52621, Ramat Gan, Israel.
7
Division Reproductive Endocrinology-IVF, Department of Obstetrics and Gynecology, Carmel Medical Center, Ruth and Bruce Faculty of Medicine, Technion, 3436212, Haifa, Israel.
8
Yale Fertility Center, Yale University, 150 Sargent Drive, New Haven, CT, 06511, USA.

Abstract

PURPOSE:

This binational qualitative study of medical egg freezing (MEF) examined women's motivations and experiences, including their perceived needs for patient-centered care in the midst of fertility- and life-threatening diagnoses.

METHODS:

Forty-five women who had undertaken MEF were interviewed in the USA (33 women) and in Israel (12 women) between June 2014 and August 2016. Interviews lasted approximately 1 h and were conducted by two senior medical anthropologists, one in each country. Women were recruited from four American IVF clinics (two academic, two private) and two Israeli clinics (both academic) where MEF is being offered to cancer patients and women with other fertility-threatening medical conditions.

RESULTS:

Women who undertake MEF view their fertility and future motherhood as important components of their identities and recovery and, thus, are grateful for the opportunity to pursue fertility preservation. However, women who undergo MEF have special needs, given that they tend to be a "vulnerable" population of young (age < 30), unmarried, resource-constrained women, who are facing not only fertility loss but also the "double jeopardy" of cancer. Through in-depth, qualitative interviews, these women's MEF stories reveal 10 dimensions of care important to fertility preservation, including five "system factors" (information, coordination and integration, accessibility, physical comfort, cost) and five "human factors" (adolescent issues, male partner involvement, family involvement, egg disposition decisions, emotional support). Together, these dimensions of care constitute an important framework that can be best described as "patient-centered MEF."

CONCLUSIONS:

Women pursuing MEF have special medical needs and concerns, which require particular forms of patient-centered care. This study outlines 10 dimensions of patient-centered fertility preservation that are appropriate for MEF patients. This approach may help IVF clinics to be better prepared for delivering top-quality care to mostly young, single women facing the daunting prospect of fertility loss and life-threatening medical diagnoses.

KEYWORDS:

Cancer; Israel; Medical egg freezing (MEF); Patient-centered care; United States

PMID:
29124460
PMCID:
PMC5758476
DOI:
10.1007/s10815-017-1081-5
[Indexed for MEDLINE]
Free PMC Article

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