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J Assist Reprod Genet. 2019 Jun;36(6):1081-1090. doi: 10.1007/s10815-019-01481-2. Epub 2019 May 18.

Patient-centered elective egg freezing: a binational qualitative study of best practices for women's quality of care.

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Department of Anthropology, Yale University, 10 Sachem Street, New Haven, CT, 06520, USA.
Department of Nursing, University of Haifa, 3498838, Haifa, Israel.
Stanford Fertility and Reproductive Medicine Center, Stanford University, 1195 W. Fremont Ave, Sunnyvale, CA, 94087, USA.
Shady Grove Fertility, 9600 Blackwell Road, Rockville, MD, 20850, USA.
Center for Human Reproduction, 21 E. 69th Street, New York, NY, 10021, USA.
Division Reproductive Endocrinology-IVF, Department of Obstetrics & Gynecology, Carmel Medical Center, Ruth & Bruce Faculty of Medicine, Technion, 3436212, Haifa, Israel.
Clinical Center for Fertility Preservation and Fertility Preservation Research Laboratory, Department of Obstetrics and Gynecology, Sheba Medical Center, IVF and Fertility Unit, 1 Emek Ha'ella St, 52621, Ramat Gan, Israel.
Department of Obstetrics and Gynecology, Sheba Medical Center, IVF and Fertility Unit, 1 Emek Ha'ella St, 52621, Ramat Gan, Israel.
Assuta Medical Center, 13 Eliezer Mazal, 75653, Rishoon Lezion, Israel.
Yale Fertility Center, Yale University, 150 Sargent Drive, New Haven, CT, 06511, USA.



How can elective egg freezing (EEF) be made patient centered? This study asked women to reflect on their experiences of EEF, which included their insights and recommendations on the optimal delivery of patient-centered care.


In this binational, qualitative study, 150 women (114 in the USA, 36 in Israel) who had completed at least one cycle of EEF were recruited from four American IVF clinics (two academic, two private) and three in Israel (one academic, two private) over a two-year period (June 2014-August 2016). Women who volunteered for the study were interviewed by two medical anthropologists. Interviews were audio recorded, transcribed, and entered into a qualitative data management program (Dedoose) for analysis.


The majority (85%) of women were without partners at the time of EEF, and thus were undertaking EEF alone in mostly couples-oriented IVF clinics. Following the conceptual framework known as "patient-centered infertility care," we identified two broad categories and eleven specific dimensions of patient-centered EEF care, including (1) system factors: information, competence of clinic and staff, coordination and integration, accessibility, physical comfort, continuity and transition, and cost and (2) human factors: attitude and relationship with staff, communication, patient involvement and privacy, and emotional support. Cost was a unique factor of importance in both countries, despite their different healthcare delivery systems.


Single women who are pursuing EEF alone in the mostly couples-oriented world of IVF have distinct and multifaceted needs. IVF clinics should strive to make best practices for patient-centered EEF care a high priority.


Elective egg freezing; Fertility preservation; Israel; Patient-centered care; United States

[Available on 2020-06-01]

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