Hum. Reprod. Advance Access originally published online on March 31, 2005
Human Reproduction 2005 20(7):1944-1951; doi:10.1093/humrep/deh857
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A qualitative study of women's decision-making at the end of IVF treatment
1 Department of Obstetrics and Gynaecology, Assisted Reproduction Unit, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen, AB25 2ZL and 2 Medical School, Polwarth Building, Aberdeen, AB25 2ZD, UK
3 To whom correspondence should be addressed. Email: v.peddie{at}abdn.ac.uk
BACKGROUND: The decision not to pursue further in vitro fertilization (IVF) after one or more unsuccessful attempts is an important and often difficult one for couples. Relatively little is known about the woman's perception of this decision-making process. The aim of this study was to examine patients' perspectives of decision-making, including circumstances influencing it and satisfaction with the decision-making process. METHODS: Semi-structured interviews were conducted with a purposive sample of 25 women who had decided to end treatment after unsuccessful IVF treatment. Interviews were tape-recorded and transcribed by means of thematic analysis using the open coding technique. RESULTS: Women experienced difficulty in accepting that their infertility would remain unresolved. Many felt that they had started with unrealistic expectations of treatment success and felt vulnerable to the pressures of both the media and society. Although the decision to end treatment was difficult, it offered many women a way out of the emotional distress caused by IVF; however, the process of decision-making created a sense of ‘confrontation’ for the women in which they had to address issues they had previously avoided. Adoptive parents perceived less societal pressure than those who remained childless. CONCLUSIONS: Efforts to improve the psychological preparation of couples who decide to end IVF treatment should be directed towards examination of the existing system of consultation, which has certain limitations in terms of the quality of communication and the provision of post-treatment support. Further efforts to develop strategies, which facilitate the decision-making process, should be considered.
Key words: decision-making/ending treatment/in vitro fertilization/perceptions
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